Individual provider Active NPI

Joseph P McDaniel, PA

  • Physician Assistant
  • Hinsdale, IL
National Provider Identifier
1003452160
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PENDING Issued in IL
Practice address
550 W Ogden Ave
Hinsdale, IL 60521-3186
Phone
(630) 323-6116
Fax
(630) 794-8620
NPI assigned
Nov 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PENDING IL Primary

Addresses

Primary practice location

550 W Ogden Ave
Hinsdale, IL 60521-3186

Mailing address

1010 Executive Dr Ste 250
Westmont, IL 60559-6137
Phone (630) 323-6116

Other practice location 1

1010 Executive Dr Ste 250
Westmont, IL 60559-6137
Phone (630) 323-6116

Other practice location 2

1200 S York St Ste 4110
Elmhurst, IL 60126-5630
Phone (630) 279-2401

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherILILLINOIS PA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241217000303 OH Practitioner - Physician Assistant 3971939935
I20250718001228 PA Practitioner - Physician Assistant 3971939935 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGILMDSports Medicine (Orthopaedic Surgery) Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEAEAD/Endpoint/DEAEAD
  • Direct secure messaging: joseph.mcdaniel.1@3342.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1003452160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 EXECUTIVE DR STE 250",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605596137",
            "telephone_number": "630-323-6116",
            "fax_number": "630-794-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213186",
            "telephone_number": "630-323-6116",
            "fax_number": "630-794-8620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Executive Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605596137",
            "country_code": "US",
            "telephone_number": "630-323-6116",
            "fax_number": "630-794-8620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 S York St Ste 4110",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601265630",
            "country_code": "US",
            "telephone_number": "630-279-2401",
            "fax_number": "630-794-8620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PA LICENSE",
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.