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

Nicholas James Peterson, PT

Individual provider Physical Therapist · NPI 1053035261

Nicholas James Peterson, PT is a Physical Therapist in Private Practice in LA Crosse, Wisconsin. Qualified in 2022, 4 years ago. Practices with Summit Physical Therapy Inc, a 13-clinician group and accepts Medicare assignment. Licensed in Minnesota and Wisconsin.

Years since qualifying
4
Licensed in
MN, WI
In the registry since
2022
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1836 S Ave
LA Crosse, WI 54601-5429
Phone: (608) 782-7300
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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 16111 (WI)
Physical Therapist Taxonomy 225100000X · Licence 13206 (MN)

Record details

NPI number1053035261
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedSeptember 30, 2022
Last updated in NPPESAugust 1, 2023
Certification dateAugust 1, 2023
Mailing address1836 South Ave, La Crosse, WI 54601-5429

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Summit Physical Therapy Inc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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