Rachael Wiley Nicolaisen, DPT in Los Angeles, CA - Medicare Physical Therapist Provider

Rachael Wiley Nicolaisen, DPT is a medicare enrolled "Physical Therapist" provider in Los Angeles, California. Her current practice location is 6041 Cadillac Ave, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at (541) 521-8867.

Rachael Wiley Nicolaisen is licensed to practice in California (license number 28739) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1700949344.

Contact Information

	Rachael Wiley Nicolaisen, DPT
	6041 Cadillac Ave, Los Angeles, CA 90034-1702
	(541) 521-8867
	(541) 521-8867

Map and Direction

Healthcare Provider's Profile

Full Name	Rachael Wiley Nicolaisen
Gender	Female
Speciality	Physical Therapist
Location	6041 Cadillac Ave, Los Angeles, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1700949344
Provider Enumeration Date: 12/18/2006
Last Update Date: 12/02/2021

Medicare PECOS Information:

PECOS PAC ID: 1850280041
Enrollment ID: I20040315000601

Medical Identifiers

Medical identifiers for Rachael Wiley Nicolaisen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700949344	NPI	-	NPPES
28739	Other	CA	PT LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	28739 (California)	Primary

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. Rachael Wiley Nicolaisen allows following entities to bill medicare on her behalf.

Provider Name	Southern California Permanente Medical Group
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678

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. Rachael Wiley Nicolaisen 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
Rachael Wiley Nicolaisen, DPT 4330 Kraft Ave, Studio City, CA 91604-2741 Ph: (541) 521-8867	Rachael Wiley Nicolaisen, DPT 6041 Cadillac Ave, Los Angeles, CA 90034-1702 Ph: (541) 521-8867

Reviews and Comments

Physical Therapist in Los Angeles, CA

Miss Jill M Werner, B.SC.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1720 Cesar E Chavez Ave., Los Angeles, CA 90033 Phone: 323-268-5000
Ms. Peggy Sue Perock, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 335 N La Brea Street, Bob Hope Medical Clinic, Los Angeles, CA 90036 Phone: 323-634-3826 Fax: 323-938-9958
Jessica Elizabeth Greim, DPT, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4650 W Sunset Blvd, Los Angeles, CA 90027 Phone: 310-361-2118
Mrs. Christy Lynn Skura, DPT, PCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8717 Venice Blvd, Los Angeles, CA 90034 Phone: 310-337-7115 Fax: 310-216-6153
Dr. Sean Dennis Johnson, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 488 S San Vicente Blvd, Los Angeles, CA 90048 Phone: 323-655-9055
Izumi Yasuhara, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 6080 Center Dr Fl 6, Los Angeles, CA 90045 Phone: 888-859-0145
Ritchie Val Aguilera, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2040 Fair Park Ave, Apt 206, Los Angeles, CA 90041 Phone: 818-985-5990

Rachael Wiley Nicolaisen, DPT - Medicare Physical Therapist in Los Angeles, CA