NICHOLE WAXMAN (DPT, LATC) – Physical Therapist, NPI 1477195097

NICHOLE WAXMAN (DPT, LATC) is a healthcare provider. based in Auburn, Massachusetts. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT, LATC. They hold a License No. 2921 (). The NPI Number for NICHOLE WAXMAN (DPT, LATC) is 1477195097

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLE WAXMAN (DPT, LATC)
NPI
1477195097
Phone
(774) 696-8309
Address
489 WASHINGTON ST STE 200
Enumeration Date
15 October 2019
Last Update Date
15 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5082787810
Graduation Year
2019 (7 years ago)
PAC ID
3678805835
Group Practice PAC ID
9436118197
Professional Enrollment ID
I20191022000411
Address ID
MA015691628UX60XXXHWYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:6State licenses:2Digital endpointsOther names

2,873 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MA

Provider Addresses for NICHOLE WAXMAN (DPT, LATC)

  • 489 WASHINGTON ST STE 200

    AUBURN, MA 015015709

    Phone: (774) 696-8309

    Fax: (508) 297-8416

    Type: Location

  • 489 Washington St Ste 200

    Auburn, MA 015015709

    Phone: (774) 696-8309

    Fax: (508) 297-8416

    Type: Location

  • 60 QUAKER HWY

    UXBRIDGE, MA 015691628

    Phone: (508) 278-7810

    Type: Location

  • 19 SALO TER

    MILLBURY, MA 015271940

    Phone: (774) 277-1095

    Fax: (508) 297-8416

    Type: Mailing

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: 2019-10-22

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
I20191022000411IPhysical Therapist In Private PracticeMATBD

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 01501)

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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: 9436118197View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNH
Physical Therapist In Private PracticeMA
Registered Dietitian Or Nutrition ProfessionalMA

Reviews

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Frequently asked questions

How do I look up NICHOLE WAXMAN (DPT, LATC) by NPI?
Use NPI 1477195097 when you need to reference NICHOLE WAXMAN (DPT, LATC) in forms, claims, or directories.
Does this profile mean NICHOLE WAXMAN (DPT, LATC) is currently active?
Yes — NICHOLE WAXMAN (DPT, LATC) appears active in the national provider directory.
What does NICHOLE WAXMAN (DPT, LATC) treat or focus on?
Patients typically see NICHOLE WAXMAN (DPT, LATC) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Does NICHOLE WAXMAN (DPT, LATC) practice in Massachusetts?
You will see Auburn, Massachusetts on file for NICHOLE WAXMAN (DPT, LATC) 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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