Daniel Patrick Nicoli, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO173799 Issued in OR

Practice address

1225 NE 2ND Ave
Portland, OR 97232-2003

Phone

(503) 944-8000

Fax

(503) 944-8017

NPI assigned

Mar 25, 2014

Last updated

Aug 23, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dnicoli84918@direct.ohsu.edu

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.

• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment NPD
• New Narrative

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tigard, OR
  • NPI 1265595664
  Medicare reassignment NPD
• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Psychiatry

  NPD
• University Professional Services

  dba OHSU Home Infusion Pharmacy

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  dba Child Development & Rehabilitation Center in Portland

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1073767588
  NPD
• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  NPD

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1518384791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 E 17TH PL, CAMPUS BOX F546",
            "address_2": "BLDG. 500 ROOM E2322",
            "city": "AURORA",
            "state": "OR",
            "postal_code": "800454290",
            "telephone_number": "720-777-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 NE 2ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322003",
            "telephone_number": "503-944-8000",
            "fax_number": "503-944-8017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLI",
        "first_name": "DANIEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "DO173799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luciano Nicolas Jr.
• Grant Nicolaus
• Nicole Brown Prof Corp
• Nicole Holton, DC, PC
• Andrea Nicolet
• Roslyn Nicoll
• Alexander Demetre Nicoloff, M.D.
• Ron Nida
• Mary Anne Joseph Nidiry, MD
• Dolores A Niebergall, PT

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.