Niccole J. Mack, D.P.T.
NPI 1063401503ActiveIndividual· Physical Therapist· Watertown, SD
Physical Therapist (D.P.T.) with Sanford Medical Center, practicing in Watertown, South Dakota. Medicare paid $6,621 for services to 14 patients in 2024.
Overview
| NPI | 1063401503 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.P.T. |
| Sole proprietor | No |
| NPI issued | Oct 18, 2005 |
| Last updated in NPPES | Nov 5, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 1225 | SD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (SD) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 14 |
|---|---|
| Services billed | 374 across 11 procedure codes |
| Paid by Medicare | $6,621 |
Education and affiliations
| Graduation year | 2003 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Sanford Medical CenterSioux Falls, SD · 857 clinicians
Other physical therapists in Watertown
- 1134538085
- 1306871165
- 1336146398
- 1407012420
- 1447848478
- 1477818847
- 1487666533
- 1578923975
- 1619388154
- 1629417415
- 1669880969
- 1689279119
All 45 physical therapists in Watertown · All physical therapists in South Dakota