CMS-1500 Box 24J / 33a • NPI
1073296695
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
225100000X (CMS 65)
Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist
Box 32 Service Location & ZIP+4
1040 WHITTIER HWY, MOULTONBOROUGH, NH, 03254
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1073296695 (MIKAELA LESLIE SHIELDS, DPT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1073296695)
Medicare Beneficiaries
94
Total Billed Services
2,294
Distinct CPT/HCPCS Codes
8
Medicare Allowed Total
$60,710.62
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1,391 |
97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 230 |
97140 | Therapy procedure using manual technique, each 15 minutes | 531 |
97161 | Evaluation for physical therapy, typically 20 minutes | 39 |
97162 | Evaluation for physical therapy, typically 30 minutes | 21 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1073296695 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MIKAELA LESLIE SHIELDS, DPT |
| Plain-English Specialty | Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist NUCC Code: 225100000X (Physical Therapist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1040 WHITTIER HWY, MOULTONBOROUGH, NH, 03254 |
| Practice Telephone / Fax | Tel: (603) 273-1570 |
| Administrative Mailing Address | PO BOX 121, CORNISH, ME, 04020-0121 |
| Enumeration & Last Sync | Enumerated: 2023-08-10 | CMS Record Updated: 2023-08-24 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (225100000X)
What Does Taxonomy Code 225100000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225100000X translates to:
"Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MIKAELA LESLIE SHIELDS, DPT)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: NH | License: 5200 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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