Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Niccolo Iannello, DPT

Individual provider Physical Therapist · NPI 1043145121

Niccolo Iannello, DPT is a Physical Therapist in Private Practice in Surprise, Arizona. Practices with Foothills Sports Medicine and Rehabilitation LLC, a 173-clinician group and accepts Medicare assignment. Licensed in Arizona.

Licensed in
AZ
In the registry since
2026
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

13967 W Grand Ave Ste 100
Surprise, AZ 85374-3732
Phone: (623) 474-3952
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence LPT-034828 (AZ)

Record details

NPI number1043145121
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJune 17, 2026
Last updated in NPPESJune 17, 2026
Certification dateJune 17, 2026
Mailing address5016 N 196th Ave, Litchfield Park, AZ 85340-9582

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2026 (0 years in practice)
Group practice Foothills Sports Medicine And Rehabilitation Llc — 173 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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