Tamara A Nicksic, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05002433A Issued in IN

Practice address

8259 Wicker Ave
Saint John, IN 46373-8878

Phone

(219) 365-6560

Fax

(219) 365-6561

NPI assigned

Jul 12, 2007

Last updated

Nov 8, 2018By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Northwestern University Feinberg Medical School, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeshore Bone and Joint Institute, PCGroup PAC ID 3173500519, 82 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.8 of 100Reported as group

Quality

81.02

Improvement activities

40

Cost

74.12

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeshore Bone & Joint Institute, PC

  • Specialist
  • Chesterton, IN
  • NPI 1508853953
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1649479544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 WYNNEWOOD DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463852828",
            "telephone_number": "219-789-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8259 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738878",
            "telephone_number": "219-365-6560",
            "fax_number": "219-365-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKSIC",
        "first_name": "TAMARA",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002433A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPT",
            "identifier": "05002433A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nanette Stokes Family Counseling Center
• Guadalupe Navarro
• NBHT Indiana (Vision Boutique)
• Jose Enrique Negrete, LSW
• Jane Neidy
• Mia Nisle
• Northshore Health Centers, Inc. (NorthShore St. John Community Health Center)
• Northwest Pediatric Dental LLC (Southwest Pediatric Dental)
• Courtney Olavarria, RN
• Nicole Lynn Olen, RDN, CHC

• Physical Therapist in Saint John, IN
• Providers in Saint John, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.