JARED R NIKODEM (PT) – Physical Therapist, NPI 1003602434

JARED R NIKODEM (PT) is a healthcare provider. based in Atlanta, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT42922 (FL). The NPI Number for JARED R NIKODEM (PT) is 1003602434

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
JARED R NIKODEM (PT)
NPI
1003602434
Phone
(856) 678-3484
Address
PO BOX 932184
Enumeration Date
15 April 2025
Last Update Date
15 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
8006999395
Graduation Year
2024 (2 years ago)
PAC ID
9436677127
Group Practice PAC ID
3971411851
Professional Enrollment ID
I20250516000770
Address ID
FL342024208LA8220XWAYX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for JARED R NIKODEM (PT)

  • PO BOX 932184

    ATLANTA, GA 311932184

    Phone: (856) 678-3484

    Type: Mailing

  • 484 RIVERSIDE AVE

    JACKSONVILLE, FL 322024912

    Phone: (904) 579-2824

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250516000770IPhysical Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31193)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971411851View full group profile
NameSpecialtyState
Family PracticeFL
Hand Surgery, Orthopedic SurgeryNY
Family Practice, Geriatric MedicineFL
Occupational Therapist In Private PracticeFL
Family PracticeFL
Physical Therapist In Private PracticeGA
Nurse PractitionerFL
Orthopedic SurgeryFL
Occupational Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

What federal number belongs to JARED R NIKODEM (PT)?
The federal identifier for JARED R NIKODEM (PT) is NPI 1003602434.
Is JARED R NIKODEM (PT) active in the national directory?
JARED R NIKODEM (PT)'s public NPI profile is in an active state.
What kind of provider is JARED R NIKODEM (PT)?
The page reflects Physical Therapist for JARED R NIKODEM (PT). Clinical services aligned with this taxonomy classification.
Does JARED R NIKODEM (PT) practice in Georgia?
You will see Atlanta, Georgia on file for JARED R NIKODEM (PT) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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