Nicole L. Pederson, DPT
NPI 1659498475ActiveIndividual· Physical Therapist· Rice Lake, WI
Physical Therapist (DPT) with Optimum Therapies of Rice Lake, practicing in Rice Lake, Wisconsin. Medicare paid $20,015 for services to 42 patients in 2024.
Overview
| NPI | 1659498475 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Mar 25, 2007 |
| Last updated in NPPES | Feb 6, 2024 |
| Certified by provider | Feb 5, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 12439 | WI |
| Specialist/Technologist, Athletic Trainer | 2255A2300X | 6343254-4810 | UT |
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 | 42 |
|---|---|
| Services billed | 955 across 9 procedure codes |
| Paid by Medicare | $20,015 |
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Optimum Therapies of Rice LakeRice Lake, WI · 6 clinicians
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All 33 physical therapists in Rice Lake · All physical therapists in Wisconsin