Jacqueline Nicholson, PT, DPT
NPI 1114430725ActiveIndividual· Physical Therapist· Jefferson, WI
Physical Therapist (PT, DPT) with Aegis Group Practice LLC and 1 other group, practicing in Jefferson, Wisconsin. Medicare paid $23,260 for services to 27 patients in 2024.
Overview
| NPI | 1114430725 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Nov 6, 2017 |
| Last updated in NPPES | Nov 6, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
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 (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 27 |
|---|---|
| Services billed | 1,172 across 10 procedure codes |
| Paid by Medicare | $23,260 |
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical groups
- Aegis Group Practice LLCToledo, OH · 390 clinicians
- Fox Rehabilitation Services Wi LLCWest Bend, WI · 148 clinicians
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