Niccole J Mack, DPT in Watertown, SD - Medicare Physical Therapy Provider

Niccole J Mack, DPT is a medicare enrolled "Physical Therapist" provider in Watertown, South Dakota. She graduated from medical school in 2003 and has 21 years of diverse experience with area of expertise as Physical Therapy. She is a member of the group practice Sanford Medical Center and her current practice location is 901 4th St Nw, Watertown, South Dakota. You can reach out to her office (for appointments etc.) via phone at (605) 886-8471.

Niccole J Mack is licensed to practice in South Dakota (license number 1225) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063401503.

Contact Information

	Niccole J Mack, DPT
	901 4th St Nw, Watertown, SD 57201-1558
	(605) 886-8471
	(605) 886-9317

Map and Direction

Healthcare Provider's Profile

Full Name	Niccole J Mack
Gender	Female
Speciality	Physical Therapy
Experience	21 Years
Location	901 4th St Nw, Watertown, South Dakota
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Niccole J Mack graduated from medical school in 2003

NPI Data:

NPI Number: 1063401503
Provider Enumeration Date: 10/18/2005
Last Update Date: 11/05/2013

Medicare PECOS Information:

PECOS PAC ID: 0941232235
Enrollment ID: I20050907001127

Medical Identifiers

Medical identifiers for Niccole J Mack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063401503	NPI	-	NPPES
5834040	Medicaid	SD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	1225 (South Dakota)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Sanford Medical Center	8325950215	707

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Niccole J Mack allows following entities to bill medicare on her behalf.

Provider Name	Sanford Clinic
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1396764254 PECOS PAC ID: 0244143824 Enrollment ID: O20031110000532

Provider Name	Sanford Medical Center
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1821017880 PECOS PAC ID: 8325950215 Enrollment ID: O20040115000388

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Niccole J Mack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Niccole J Mack, DPT Po Box 5074, Sioux Falls, SD 57117-5074 Ph: (605) 328-6585	Niccole J Mack, DPT 901 4th St Nw, Watertown, SD 57201-1558 Ph: (605) 886-8471

Reviews and Comments

Physical Therapist in Watertown, SD

Kris Cleveland, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 810 S Maple, Watertown, SD 57201 Phone: 605-753-5400
Stephanie L Lenards, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1516 4th St Ne, Watertown, SD 57201 Phone: 605-753-0430
Casey Grimsrud, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 901 4th St Nw, Watertown, SD 57201 Phone: 605-886-8471 Fax: 605-886-9317
Mr. Nathan Lee Breske, DPT, ATC Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1516 4th St Ne, Watertown, SD 57201 Phone: 605-753-0430 Fax: 605-753-2663
Riley Wilson, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 415 4th Ave Ne, Watertown, SD 57201 Phone: 605-886-8431
Lynn Simon, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 8 5th St Se, Watertown, SD 57201 Phone: 605-753-5400 Fax: 605-753-6208

Niccole J Mack, DPT - Medicare Physical Therapist in Watertown, SD