Nicole Midtlyng, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT38235 Issued in CA

Practice address

7777 Norris Canyon Rd
San Ramon, CA 94583-5404

Phone

(925) 275-8836

NPI assigned

May 7, 2019

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rise Physical Therapy and Pilates IncGroup PAC ID 7911334123, 7 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.

• Rise Physical Therapy and Pilates Inc.

  • Physical Medicine & Rehabilitation Physician
  • Walnut Creek, CA
  • NPI 1710521414
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1952966798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 NORRIS CANYON RD",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 NORRIS CANYON RD",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835404",
            "telephone_number": "925-275-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDTLYNG",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT38235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Miao, PHARMD
• Michael Duong OD Inc
• Michael Duong, OD
• Michael Lee Wynn MD Inc
• Michael T. Temkin DO, a Medical Corporation
• Tatiana Mielezko
• Tatyana O Mikerina
• Ronald Miklebost, D.C.
• Nahal Erfan Milani, DMD
• Aiste Miliauskaite

• Physical Medicine & Rehabilitation Physician in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.