Individual provider Active NPI

Daniel Nicoli, M.D.

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1225076581
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
89502 Issued in SC
Practice address
2095 Henry Tecklenburg Dr Ste 5
Charleston, SC 29414-5733
Phone
(843) 402-1436
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 89502 SC Primary

Addresses

Primary practice location

2095 Henry Tecklenburg Dr Ste 5
Charleston, SC 29414-5733

Mailing address

PO Box 603484
Charlotte, NC 28260-3484
Phone (803) 765-1838

Other identifiers 2

IdentifierTypeStateIssuer
895026MedicaidSC
104288321MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210614003243 NH Practitioner - Anesthesiology 7517925241 Reassigns benefits to 2 organizations
I20240226000045 SC Practitioner - Anesthesiology 7517925241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Vermont College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
89502SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia New Hampshire LLP Anesthesiology CurrentSince Jul 24, 2022 Accepting new patients
Anesthesia Care Group PC Anesthesiology CurrentSince May 11, 2021 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Anesthesia Associates of Charleston, P.a. Anesthesiology CurrentSince Jan 14, 2024 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Sep 2, 2023 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. Anesthesiology CurrentSince Sep 2, 2023 Accepting new patients
Northland Anesthesia Associates, PC Anesthesiology PastSince Jul 1, 1995 Accepting new patients

Locations

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

11 Whitehall Rd
Rochester, NH 03867
Phone (603) 330-7905

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

2095 Henry Tecklenburg Dr
Ste 5
Charleston, SC 29414
Phone (843) 402-1436

1064 Gardner Rd
Ste 112
Charleston, SC 29407
Phone (843) 723-3441

Organizations & group practices 7

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 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1225076581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603484",
            "telephone_number": "803-765-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR STE 5",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLI",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "89502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "895026",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104288321",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.