Individual provider Active NPI

Daniel Neville

  • Surgical Physician Assistant
  • Medford, OR
National Provider Identifier
1033588546
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA172403 Issued in OR
Practice address
520 Medical Center Dr
Suite 201
Medford, OR 97504-4334
Phone
(541) 789-5710
Fax
(541) 789-5711
NPI assigned
Sep 15, 2015
Last updated
Apr 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA172403 OR Primary

Addresses

Primary practice location

520 Medical Center Dr
Suite 201
Medford, OR 97504-4334

Mailing address

2620 E Barnett Rd
Suite H
Medford, OR 97504-8344
Phone (541) 789-4281

Other practice location 1

3640 NW Samaritan Dr Ste 120
Corvallis, OR 97330-3738
Phone (541) 768-5223

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dneville261757@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151028002142 OR Practitioner - Physician Assistant 5597074708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

625 SW Ramsey Ave
Suite a
Grants Pass, OR 97527-5808
Phone (541) 507-2290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA172403ORMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
App Cardiovascular Surgeons Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dan.neville@jhie.net

Organizations & group practices 2

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1033588546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E BARNETT RD",
            "address_2": "SUITE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048344",
            "telephone_number": "541-789-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "SUITE 201",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044334",
            "telephone_number": "541-789-5710",
            "fax_number": "541-789-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303738",
            "country_code": "US",
            "telephone_number": "541-768-5223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA172403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dneville261757@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.