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

Nicole Ellis, PT, DPT

Individual provider Physical Therapist · NPI 1912594144

Nicole Ellis, PT, DPT is a Physical Therapist in Private Practice in Bloomfield, New Jersey. Qualified in 2020, 6 years ago. Practices with Ivyrehab Network Inc, a 653-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
6
Licensed in
NJ
In the registry since
2020
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1255 Broad St Ste 207
Bloomfield, NJ 07003-3061
Phone: (973) 893-9300
Fax: (973) 893-0073
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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 40QA01974800 (NJ)

Record details

NPI number1912594144
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedDecember 22, 2020
Last updated in NPPESDecember 22, 2020
Certification dateDecember 22, 2020

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ivyrehab Network Inc — 653 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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