Individual provider Active NPI

Nicole Diane Cammisa, DPT

  • Physical Therapist
  • Miamisburg, OH
National Provider Identifier
1689241267
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT019358 Issued in OH
Practice address
55 Pinnacle Point Dr
Miamisburg, OH 45342-5015
Phone
(937) 886-5777
Fax
(937) 886-5774
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT019358 OH Primary

Addresses

Primary practice location

55 Pinnacle Point Dr
Miamisburg, OH 45342-5015

Mailing address

PO Box 643398
Cincinnati, OH 45264-3398
Phone (513) 221-1100

Other names 1

  • Nicole Diane Retzlaff Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210617000834 OH Practitioner - Physical Therapist in Private Practice 5496155178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayfield Clinic IncGroup PAC ID 9133013006, 74 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone (513) 221-1100

55 Pinnacle Point Dr
Miamisburg, OH 45342-5015
Phone (513) 221-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1689241267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643398",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452643398",
            "telephone_number": "513-221-1100",
            "fax_number": "513-569-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PINNACLE POINT DR",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425015",
            "telephone_number": "937-886-5777",
            "fax_number": "937-886-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMMISA",
        "first_name": "NICOLE",
        "middle_name": "DIANE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT019358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "RETZLAFF",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.