Individual provider Active NPI

Todd Michael Niles, NP

  • Nurse Practitioner
  • Tecumseh, MI
National Provider Identifier
1073077715
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704223808 Issued in MI
Practice address
501 E Cummins St
Tecumseh, MI 49286-2070
Phone
(517) 424-3070
Fax
(517) 423-2786
NPI assigned
Jan 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.024070 OH
Family Nurse Practitioner 363LF0000X RN251795 OH
Nurse Practitioner 363L00000X 4704223808 MI Primary

Addresses

Primary practice location

501 E Cummins St
Tecumseh, MI 49286-2070

Mailing address

333 N Summit St FL 7
Toledo, OH 43604-1531

Other practice location 1

331 W Main St
Hudson, MI 49247-1051
Phone (517) 448-2371

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tniles134444@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 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
I20190325002504 OH Practitioner - Nurse Practitioner 3375883507 Reassigns benefits to 1 organization
I20200206000575 MI Practitioner - Nurse Practitioner 3375883507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 E Russell Rd
Unit C
Tecumseh, MI 49286-2072
Phone (517) 263-9491

501 E Cummins St
C
Tecumseh, MI 49286-2070
Phone (517) 423-3070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704223808MIMDNurse Practitioner
APRN.CNP.024070OHMDNurse Practitioner
RN251795OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Nurse Practitioner CurrentSince Apr 1, 2019 Accepting new patients
Promedica Central Corporation of Michigan CurrentSince Dec 25, 2019 Accepting new patients
Promedica Central Physicians CurrentSince Apr 1, 2019 Accepting new patients

Locations

777 Kimole Ln
Ste 250
Adrian, MI 49221
Phone (517) 265-3411

331 W Main St
Hudson, MI 49247
Phone (517) 448-2371

1180 N Monroe St
Monroe, MI 48162
Phone (734) 243-5300

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

501 E Cummins St
Tecumseh, MI 49286
Phone (517) 423-2960

501 E Cummins St
#C
Tecumseh, MI 49286

5300 Harroun Rd
Ste 304
Sylvania, OH 43560
Phone (419) 824-1100

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

Interoperability endpoints

  • Direct secure messaging: tniles134444@direct.promedica.org

Organizations & group practices 3

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.

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": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1073077715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E CUMMINS ST",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492862070",
            "telephone_number": "517-424-3070",
            "fax_number": "517-423-2786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 W Main St",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "MI",
            "postal_code": "492471051",
            "country_code": "US",
            "telephone_number": "517-448-2371",
            "fax_number": "517-448-7313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NILES",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-28",
        "last_updated": "2023-11-03",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.024070",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN251795",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704223808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tniles134444@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tecumseh, MI

Sources for this page

Verify at the official NPI Registry.