Nicole Todisco Macdonald, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62809 Issued in OR

Practice address

345 SW Cyber Dr Ste 104
Bend, OR 97702-1045

Phone

(802) 318-2254

NPI assigned

Jun 11, 2018

Last updated

Mar 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole Ann Todisco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Outside Movement Physical Therapy

  • Physical Therapy Clinic/Center
  • Bend, OR
  • NPI 1871191981
  NPD
• Morgan Kriz PLLC

  dba Vestibular Therapy Specialists

  • Physical Therapy Clinic/Center
  • Seattle, WA
  • NPI 1194360255

  Physical Therapist

  NPD
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)
• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1285127571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 NE SHEPARD RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014164",
            "telephone_number": "802-318-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SW CYBER DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021045",
            "telephone_number": "802-318-2254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17355 Boones Ferry Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Lake Oswego",
            "state": "OR",
            "postal_code": "97035",
            "country_code": "US",
            "telephone_number": "503-635-0844",
            "fax_number": "503-635-0812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "NICOLE",
        "middle_name": "TODISCO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2022-03-21",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500744539",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "TODISCO",
            "middle_name": "ANN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• M. Belza Consulting, LLC.
• M. Jamie McAllister, D. O., P. C.
• Megan Maccoy
• Alexander 'Sandy' Frederick Macdonald, LCSW
• Katherine Macdonald, LPC
• Aimee Elizabeth Macdonell I, OTR/L
• Richard A Macdonell, MD
• Carol Macdougall
• Joshua Macdougall
• Kelly-Anne Fleischner Macdowell

• Physical Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.