Nicole K Pitkanen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27249 Issued in MD

Practice address

Fyzical
11204 Racetrack Rd
Berlin, MD 21811

Phone

(410) 208-1525

Fax

(410) 208-1527

NPI assigned

Apr 13, 2021

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 K Austin Former name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

AquaworxGroup PAC ID 4082891759, 8 clinicians

Practice addresses (Care Compare)

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.

• Aquaworx

  • Physical Therapist
  • Berlin, MD
  • NPI 1912204983
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1366022402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FYZICAL",
            "address_2": "11204 RACETRACK RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-208-1525",
            "fax_number": "410-208-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FYZICAL",
            "address_2": "11204 RACETRACK RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-208-1525",
            "fax_number": "410-208-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITKANEN",
        "first_name": "NICOLE",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-01-08",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "AUSTIN",
            "middle_name": "K",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mandy R. Phillips
• Zenia Phillips
• Patricia Anne Picard
• Lacey J Pierson, R.D
• Erika Pinto, PA-C
• Lisa Podlesny, R.N.
• Amanda Pollack
• Kimberly J Poole-Sykes, LCPC
• Patrice E Porter
• Brittany Rena Powell

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.