Niccolo Iannello, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-034828 Issued in AZ

Practice address

13967 W Grand Ave Ste 100
Surprise, AZ 85374-3732

Phone

(623) 474-3952

NPI assigned

Jun 17, 2026

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2026

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothills Sports Medicine and Rehabilitation LLCGroup PAC ID 2668457979, shared by 3 NPIs, 172 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1781654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1043145121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 N 196TH AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13967 W GRAND AVE STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743732",
            "telephone_number": "623-474-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNELLO",
        "first_name": "NICCOLO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-17",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-034828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lamont Hutchinson, PTA
• Ly Khanh Huynh, DMD
• Quy Huynh
• Stefan Iacob, PA-C
• Hanna Ian, N.M.D.
• David Iannicca, ATC
• Rachel Iannucci, C.O.T.A.
• Geoff Ross Ibe, FNP-BC
• Haifaa Ibrahim
• Safi Ibrahim

• Physical Therapist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.