Nicole Surdyka, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-033823 Issued in AZ

Practice address

765 N 114TH Ave Ste 101
Avondale, AZ 85323-5003

Phone

(602) 933-7778

NPI assigned

Oct 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Canning Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

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.

• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1184176109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167761",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 N 114TH AVE STE 101",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853235003",
            "telephone_number": "602-933-7778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3116 W Augusta Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850516530",
            "country_code": "US",
            "telephone_number": "908-433-7318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURDYKA",
        "first_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43065",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-033823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "CANNING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sun Valley Medical Group
• Sun Valley Pediatric Dentistry, PLLC
• Sunbridge Healthcare LLC
• Sunny Internal Medicine and Pediatrics, PLLC
• Sunnyside Assisted Living LLC
• Surgical Elite of Avondale, LLC
• Richard Alexander Swartz, DC
• Riley Frederick Sweetland
• T & J Health Care
• T & L Foot & Ankle Surgeons

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.