Nikolai S Miskov, DPT – Physical Therapist

Key facts

NPI: 1063863264
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 13558-24 (WI)
Practice address: 25250 75TH St
Salem, WI 53168-8705
Phone: (262) 843-4200
Fax: (262) 843-4578
NPI assigned: Jun 29, 2016
Sex: Male
Sole proprietor: No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Athletico LTD Physical Therapist · Oak Brook, IL · NPI 1821085028

Medicare reassignment NPD PHYSICAL THERAPIST · WI
Athletico LTD Clinic/Center · Milwaukee, WI · NPI 1083940274

NPD PHYSICAL THERAPIST
Athletico LTD Clinic/Center · Lafayette, IN · NPI 1053044867

NPD PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty: Physical Therapist in Private Practice
Education: Other, 2016
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Athletico LTD (2,187 clinicians)

Practice addresses (Care Compare)

15175 W National Ave
New Berlin, WI 53151-5150
Phone (262) 649-2135

2615 N Downer Ave
Milwaukee, WI 53211-4245
Phone (414) 962-4400

3077 N Mayfair Rd
Suite 105
Wauwatosa, WI 53222-4305
Phone (414) 455-5797

5708 B 75TH St
Kenosha, WI 53142-3635
Phone (262) 697-9135

Merit-based Incentive Payment System (MIPS)

Final score: 86.32 of 100 (group)
Quality: 84.44
Promoting interoperability: 99
Improvement activities: 40
Cost: 70.78

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WI

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20161031000061	WI	Practitioner - Physical Therapist in Private Practice	4789962580	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Athletico LTD	Physical Therapist	Current since Dec 1, 2018	Accepting new patients
Athletico LTD	Physical Therapist	Current	Accepting new patients
Athletico LTD	Physical Therapist	Current since Dec 1, 2018	Accepting new patients

Locations

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

3701 80th St
Kenosha, WI 53142
Phone (262) 697-1730

5708 75th St
#B
Kenosha, WI 53142
Phone (262) 697-9135

2615 N Downer Ave
Milwaukee, WI 53211
Phone (414) 962-4400

15175 W National Ave
New Berlin, WI 53151
Phone (262) 649-2135

25250 75th St
Salem, WI 53168
Phone (262) 843-4200

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	13558-24	WI	Yes

Addresses

Primary practice location

25250 75TH St
Salem, WI 53168-8705

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 590-4029

Other providers in Salem, WI

All providers in Salem, WI · Physical Therapist in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.