Active NPI
Daniel Nathan Nichols, PA-C
- Physician Assistant
- Cleveland, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 015383-1
- Practice address
- 2500 Metrohealth Dr
Cleveland, OH 44109-1900 - Phone
- (216) 778-7800
- NPI assigned
- Oct 11, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 015383-1 | NY | Primary |
| Physician Assistant | 363A00000X | PA9119112 | FL | |
| Physician Assistant | 363A00000X | 2271845 | ID | |
| Surgical Physician Assistant | 363AS0400X | 015383-1 | NY |
Addresses
Primary practice location
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Mailing address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800
Other practice location 1
800 Meadows Rd
Boca Raton, FL 33486-2304
Phone (561) 955-7100
Other practice location 2
190 E Bannock St Fl 10
Boise, ID 83712-6241
Phone (208) 381-5500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043595911 | Other | NY | UNIVERA |
| 120326000119 | Other | NY | FIDELIS |
| 9516980 | Other | NY | INDEPENDENT HEALTH ASSOCIATION |
| 000534102001 | Other | NY | BCBS OF WNY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dnichols113487@direct.metrohealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800
2500 Metrohealth Dr
Cleveland, OH 44109-1998
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015383-1 | NY | MD | Speech-Language Pathologist |
| PA9119112 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients | |
| The Metrohealth System | Past | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
190 E Bannock St
#10
Boise, ID 83712
222 N 2nd St
Ste 215
Boise, ID 83702
Phone (208) 342-2706
190 E Bannock St
Fl 10
Boise, ID 83712
Phone (208) 381-5500
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
520 S Eagle Rd
Ste 1201
Meridian, ID 83642
Phone (208) 706-5988
2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348
4229 Pearl Rd
Cleveland, OH 44109
Phone (216) 459-6300
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1053353896
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
-
- Health Educator
- Cleveland, OH
- NPI 1609434323
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738800000000",
"number": "1043595911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7800"
}
],
"practiceLocations": [
{
"address_1": "800 Meadows Rd",
"address_purpose": "LOCATION",
"city": "Boca Raton",
"state": "FL",
"postal_code": "334862304",
"country_code": "US",
"telephone_number": "561-955-7100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "190 E Bannock St Fl 10",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837126241",
"country_code": "US",
"telephone_number": "208-381-5500",
"fax_number": "208-381-2555",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICHOLS",
"first_name": "DANIEL",
"middle_name": "NATHAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-11",
"last_updated": "2025-02-06",
"certification_date": "2025-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "015383-1",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9119112",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "2271845",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "015383-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "1043595911",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "120326000119",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH ASSOCIATION",
"identifier": "9516980",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF WNY",
"identifier": "000534102001",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dnichols113487@direct.metrohealth.org",
"affiliation": "N",
"address_1": "2500 Metrohealth Dr",
"city": "Cleveland",
"state": "OH",
"country_code": "US",
"postal_code": "441091900",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.