JOANNA J NICHOLAS (OTR) – Occupational Therapist, NPI 1215092341

JOANNA J NICHOLAS (OTR) is a healthcare provider. based in Fitchburg, Wisconsin. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR. They hold a License No. 3717-026 (WI). The NPI Number for JOANNA J NICHOLAS (OTR) is 1215092341

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
JOANNA J NICHOLAS (OTR)
NPI
1215092341
Phone
(608) 712-4089
Address
2318 WESTCHESTER RD
Enumeration Date
27 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9062257210
Graduation Year
2000 (26 years ago)
PAC ID
3072551399
Group Practice PAC ID
4284626391
Professional Enrollment ID
I20171023000233
Address ID
MI498554661MA200XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

500 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in WI

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Provider Addresses for JOANNA J NICHOLAS (OTR)

  • 2318, Westchester Road, Fitchburg, Dane County, Wisconsin, 53711, United States

    FITCHBURG, WI 537114372

    Phone: (608) 712-4089

    Type: Mailing

  • North Brookline Drive, Coventry Village, Madison, Dane County, Wisconsin, 53719, United States

    MADISON, WI 537193511

    Phone: (608) 833-2017

    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: 2017-10-23

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
I20171023000233IOccupational Therapist In Private PracticeMITBD

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 53711)

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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: 4284626391View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Occupational Therapist In Private PracticeMI
Nurse PractitionerMI
Physical Therapist In Private PracticeFL
Clinical Social WorkerMI
Nurse PractitionerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
-MI

Reviews

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Frequently asked questions

Can I use this page to confirm JOANNA J NICHOLAS (OTR)'s NPI?
Yes. JOANNA J NICHOLAS (OTR) is listed with NPI 1215092341 in the public NPI dataset.
Can I rely on JOANNA J NICHOLAS (OTR) being an active provider?
As of the registry snapshot, JOANNA J NICHOLAS (OTR) is marked active.
What is JOANNA J NICHOLAS (OTR) best known for clinically?
Directory data describes JOANNA J NICHOLAS (OTR) with Occupational Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for JOANNA J NICHOLAS (OTR)?
JOANNA J NICHOLAS (OTR)'s geographic hint is Fitchburg, Wisconsin in our summary view.
Why does JOANNA J NICHOLAS (OTR) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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