Active NPI
Mikhail Andrew Nikiforov, DPT
- Physical Therapist
- Peoria, AZ
National Provider Identifier
1629902382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 28620 N El Mirage Rd Ste B102
Peoria, AZ 85383-2098 - Phone
- (623) 253-3697
- NPI assigned
- Jun 9, 2026
- Last updated
- Jun 9, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
28620 N El Mirage Rd Ste B102
Peoria, AZ 85383-2098
Mailing address
2410 E Brandenberry CT Apt 1I
Arlington Heights, IL 60004-5111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780963200000",
"number": "1629902382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 E BRANDENBERRY CT APT 1I",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600045111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28620 N EL MIRAGE RD STE B102",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853832098",
"telephone_number": "623-253-3697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIKIFOROV",
"first_name": "MIKHAIL",
"middle_name": "ANDREW",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-06-09",
"last_updated": "2026-06-09",
"certification_date": "2026-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.