Nicole Christine Sandruck

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

29443 Issued in MD

Practice address

7629 Belair Rd
Nottingham, MD 21236-4003

Phone

(410) 870-2104

NPI assigned

Apr 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Christine Matelite Former name

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peake Physical Therapy IncGroup PAC ID 8628216041, 15 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.43 of 100Reported as group

Quality

85

Promoting interoperability

99

Improvement activities

40

Cost

73.92

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peake Physical Therapy Inc

  • Physical Therapist
  • Hunt Valley, MD
  • NPI 1780732982
  Medicare reassignment Care Compare group NPD
• Maryland Sportscare & Rehab LLC

  • Physical Therapist
  • Westminster, MD
  • NPI 1518951995

  DC

  Medicare reassignment NPD
• Maryland Sportscare & Rehab, LLC

  • Physical Therapist
  • Westminster, MD
  • NPI 1720445174
  NPD

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1083309504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 EVERGREEN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212345509",
            "telephone_number": "443-529-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7629 BELAIR RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364003",
            "telephone_number": "410-870-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDRUCK",
        "first_name": "NICOLE",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MATELITE",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Safe Harbor Christian Counseling
• Safe Harbor Christian Counseling
• Dejah Samuel
• Lonny Aaron Samuels, LCSW-C
• Ryan Sandoval, INTERN
• Tricia Sands
• Elizabeth Ann Santangelo, DC
• Richard James Santangelo, D.C.
• Fabius Abelard Santos
• Nina-Cecilia Venturina Santos I, DDS

• Physical Therapist in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.