Individual provider Active NPI

Daniel Charles Schroeder, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hillsboro, OR
National Provider Identifier
1598957110
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200850118NP Issued in OR
Practice address
21210 NW Mauzey Rd
Hillsboro, OR 97124-9327
Phone
(503) 439-9531
Fax
(503) 531-3841
NPI assigned
Aug 16, 2007
Last updated
Oct 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200850118NP OR Primary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X RN00168895 WA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 200642744RN OR

Addresses

Primary practice location

21210 NW Mauzey Rd
Hillsboro, OR 97124-9327

Mailing address

PO Box 82819
Portland, OR 97282-0819
Phone (503) 233-5405

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090602000147 OR Practitioner - Nurse Practitioner 7810046406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

21210 NW Mauzey Rd
Hillsboro, OR 97124-9327
Phone (503) 439-9531

8280 NE Mauzey CT
Hillsboro, OR 97124-9092
Phone (503) 439-9531

880 82ND Dr
Gladstone, OR 97027-1803
Phone (503) 659-5515

890 82ND Dr
Gladstone, OR 97027-1803
Phone (503) 659-5515

890 SE
82ND
Gladstone, OR 97027-1803
Phone (503) 659-5515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
200642744RNORMDAdult Psychiatric/Mental Health Registered Nurse
RN00168895WAMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC CurrentSince Apr 19, 2009 Accepting new patients
Western Psychological and Counseling Services LLC CurrentSince Apr 19, 2009 Accepting new patients
Western Psychological and Counseling Services PC Past Accepting new patients

Locations

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

21210 NW Mauzey Rd
Hillsboro, OR 97124
Phone (503) 439-9531

8280 NE Mauzey Ct
Hillsboro, OR 97124
Phone (503) 439-9531

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.danielschroeder@148835.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1598957110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972820819",
            "telephone_number": "503-233-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21210 NW MAUZEY RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249327",
            "telephone_number": "503-439-9531",
            "fax_number": "503-531-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "DANIEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "RN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200850118NP",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "RN00168895",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "OR",
            "license": "200642744RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.