Individual provider Active NPI

Nicole Bhalerao, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1861660169
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
273254 Issued in OR
Practice address
1706 NW Glisan St
Suite 5
Portland, OR 97209-2225
Phone
(503) 228-5000
Fax
(503) 228-5019
NPI assigned
Feb 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 273254 OR Primary

Addresses

Primary practice location

1706 NW Glisan St
Suite 5
Portland, OR 97209-2225

Mailing address

1706 NW Glisan St
Suite 5
Portland, OR 97209-2225
Phone (503) 228-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080725000613 OR Practitioner - Chiropractic 5092888974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Equilibrium LLCGroup PAC ID 1759454630, 3 clinicians

Practice addresses (Care Compare)

913 SW 16TH Ave
Portland, OR 97205-1730
Phone (503) 228-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
273254ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa Miesen, PC PastSince May 4, 2015 Accepting new patients

Organizations & group practices 2

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": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1861660169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 NW GLISAN ST",
            "address_2": "SUITE 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092225",
            "telephone_number": "503-228-5000",
            "fax_number": "503-228-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 NW GLISAN ST",
            "address_2": "SUITE 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092225",
            "telephone_number": "503-228-5000",
            "fax_number": "503-228-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHALERAO",
        "first_name": "NICOLE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273254",
            "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 Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.