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DR. NICHOLAS PECK DC
NPI 1619797495
Chiropractor - Sports Physician in Tualatin, OR

Active since October 15, 2024Accepts Medicare Assignment
8365 SW WARM SPRINGS ST, TUALATIN, OR 97062(503) 855-3375(503) 855-3043 Get Directions Write a Review

NPPES record last updated: October 15, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Nicholas Peck Dc NPPES

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

DR. NICHOLAS PECK DC (NPI 1619797495) is an individual sports physician in Tualatin, Oregon, licensed in Oregon (6411) and active in the NPI registry since October 2024. He is a graduate of Western States College Of Chiropractic (2024).

NPPES Registry Identity

NPI1619797495
Entity TypeIndividualMale
Primary Taxonomy111NS0005X
Provider Legal NameDR. NICHOLAS PECKCredential: DC
Location Address8365 SW WARM SPRINGS STTualatin, OR 97062-9003
Mailing Address8365 Sw Warm Springs StTualatin, OR 97062-9003 · (503) 855-3375 · Fax (503) 855-3043
Phone(503) 855-3375
Fax(503) 855-3043
Sole ProprietorNo
Medical School CMSWestern States College Of ChiropracticGraduated 2024
Enumeration DateOctober 15, 2024
NPPES CertifiedOctober 15, 2024
✔ NPI 1619797495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers
Taxonomy Code111NS0005X
License✔ Licensed in OR · 6411
Definition
A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.
Also ListedChiropractorTaxonomy 111N00000X · License 6411 (OR)
8365 SW WARM SPRINGS ST, Tualatin, OR 97062
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan.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

Dr. Nicholas Peck Dc 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 ID244763498
PECOS Enrollment IDI20241028001165

Medicare Billing Reassignment

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

Active Life Chiropractic And Rehab, LLC
Same address
Chiropractor
8365 SW WARM SPRINGS ST
Tualatin, OR 97062
  • Reassigned Medicare billing, Oregon enrollment
  • 3 clinicians in this Medicare group
NPI 1891196739 (503) 855-3375

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 4

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

DR. RACHAEL ELIZABETH NEWMAN DC
Chiropractor
8365 SW WARM SPRINGS ST
TUALATIN, OR 97062
Washington County (503) 855-3375
DR. RACHEL KOHN D.C.
Chiropractor
8365 SW WARM SPRINGS ST
TUALATIN, OR 97062
Washington County (503) 855-3375
ACTIVE LIFE CHIROPRACTIC AND REHAB, LLC
Chiropractor
8365 SW WARM SPRINGS ST
TUALATIN, OR 97062
Washington County (503) 855-3375
HANNAH KIM DC, MSC
Chiropractor
8365 SW WARM SPRINGS ST
TUALATIN, OR 97062
Washington County (503) 855-3375

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 Nicholas Peck's NPI number?

The NPI number for Nicholas Peck is 1619797495. It was assigned to this individual provider in the NPPES registry on October 15, 2024.

Where is Nicholas Peck located?

Nicholas Peck practices at 8365 SW Warm Springs St, Tualatin, OR 97062. The listed phone number is (503) 855-3375.

What is Nicholas Peck's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Nicholas Peck enrolled in Medicare?

Yes. Nicholas Peck 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 Nicholas Peck's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Peck reassigns Medicare benefits to Active Life Chiropractic And Rehab, LLC (Tualatin, 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 Nicholas Peck's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicholas Peck accept?

Health plans from PacificSource Health Plans and Providence Health Plan list Nicholas Peck 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 Nicholas Peck was last updated on October 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.