Nicole Mickendrow

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02174900 Issued in NJ

Practice address

798 State Route 35
Middletown, NJ 07748-3410

Phone

(732) 533-5741

NPI assigned

May 31, 2023

Last updated

May 31, 2023By 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

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Procare Rehabilitation, LLCGroup PAC ID 7214998038, 69 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Procare Rehabilitation, LLC

  • Specialist
  • Flemington, NJ
  • NPI 1134175730

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1811680317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WALTER E FORAN BLVD STE 203",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 STATE ROUTE 35",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077483410",
            "telephone_number": "732-533-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKENDROW",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02174900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Memorial Sloan Kettering Cancer Center (Memorial Sloan Kettering at Monmouth - Retail)
• Memorial Sloan Kettering Monmouth
• Eric James Mendez
• Crystal Meyerson
• Michael E Keller DMD LLC
• Kenneth Micko, P.T.
• Middletown Anesthesia
• Middletown Dental Care PA (Robert C DiBona DDS)
• Middletown Emergency Medical Services Inc
• Middletown Family Dental LLC

• Physical Therapist in Middletown, NJ
• Providers in Middletown, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.