Individual provider Active NPI

Maura Caitlin Daniels, AU.D.

  • Audiologist
  • Portland, OR
National Provider Identifier
1760047674
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
030939 Issued in OR
Practice address
2100 NE Broadway St Ste 305
Portland, OR 97232-1570
Phone
(503) 236-3368
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 030939 OR Primary

Addresses

Primary practice location

2100 NE Broadway St Ste 305
Portland, OR 97232-1570

Mailing address

2100 NE Broadway St Ste 305
Portland, OR 97232-1570
Phone (503) 236-3368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190620003496 OR Practitioner - Qualified Audiologist 2466786637 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oregon Audiology and Hearing Aid Clinic Audiologist CurrentSince Apr 1, 2020 Accepting new patients
Audiology Distribution, LLC CurrentSince Apr 1, 2020 Accepting new patients
Educational Service District 112 Past Accepting new patients

Locations

10455 Riverside Dr
West Palm Beach, FL 33410
Phone (800) 323-3277

301 NE Franklin Ave
Bend, OR 97701
Phone (541) 389-6669

2100 NE Broadway St
Ste 305
Portland, OR 97232
Phone (503) 236-3368

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.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1760047674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 305",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321570",
            "telephone_number": "503-236-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 305",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321570",
            "telephone_number": "503-236-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "MAURA",
        "middle_name": "CAITLIN",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "030939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.