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NICOLE MARIE MCDANIEL PT
NPI 1104826601
Specialist in Portland, OR

Active since July 26, 2005Accepts Medicare Assignment
530 NW 23RD AVE, SUITE #116, PORTLAND, OR 97210(971) 258-0995(844) 364-4344 Get Directions Write a Review

NPPES record last updated: February 20, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nicole Marie Mcdaniel Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE MARIE MCDANIEL PT (NPI 1104826601) is an individual specialist in Portland, Oregon, licensed in Oregon (5138) and active in the NPI registry since July 2005. She is a graduate of Other (2001).

NPPES Registry Identity

NPI1104826601
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameNICOLE MARIE MCDANIELCredential: PT
Location Address530 NW 23RD AVE, SUITE #116Portland, OR 97210-3275
Mailing Address530 Nw 23rd Ave, Suite #116Portland, OR 97210-3287 · (971) 258-0995 · Fax (844) 364-4344
Phone(971) 258-0995
Fax(844) 364-4344
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJuly 26, 2005
Last NPPES UpdateFebruary 20, 2017
✔ NPI 1104826601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in OR · 5138
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
530 NW 23RD AVE, Portland, OR 97210
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Other Names 1

Other Name (5)Nicki Mcdaniel

Other Identifiers 2

Other2914NM · State Of Nm Reg & Licens.
Medicaid17657385NM

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Marie Mcdaniel Pt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173906245
PECOS Enrollment IDI20220823001327

Medicare Billing Reassignment

Medicare enrollment records show Nicole Mcdaniel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Oregon Luna Care Physical Therapy LLC
8.9 mi
Physical Therapist
9620 NE TANASBOURNE DR STE 300
Hillsboro, OR 97124
  • Reassigned Medicare billing, Oregon enrollment
  • 79 clinicians in this Medicare group
NPI 1891397121 (866) 525-3175

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. SUSAN PEASE BANITT LCSW
Social Worker (Clinical)
530 NW 23RD AVE, SUITE 109
PORTLAND, OR 97210
Multnomah County (971) 207-2766

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Mcdaniel's NPI number?

The NPI number for Nicole Mcdaniel is 1104826601. It was assigned to this individual provider in the NPPES registry on July 26, 2005. The provider is also known as Nicki Mcdaniel.

Where is Nicole Mcdaniel located?

Nicole Mcdaniel practices at 530 NW 23rd Ave Suite #116, Portland, OR 97210. The listed phone number is (971) 258-0995.

What is Nicole Mcdaniel's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Nicole Mcdaniel enrolled in Medicare?

Yes. Nicole Mcdaniel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Nicole Mcdaniel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Mcdaniel reassigns Medicare benefits to Oregon Luna Care Physical Therapy LLC (Hillsboro, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Mcdaniel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Mcdaniel accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Nicole Mcdaniel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicole Mcdaniel was last updated on February 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.