Individual provider Active NPI

Michael O Daniels, M.D.

  • Family Medicine Physician
  • Mount Holly Springs, PA
National Provider Identifier
1912907387
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD035872E Issued in PA
Practice address
303 N Baltimore Ave
Mt Holly Springs, PA 17065-1607
Phone
(717) 486-8550
Fax
(717) 486-3022
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD035872E PA Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD035872E PA

Addresses

Primary practice location

303 N Baltimore Ave
Mt Holly Springs, PA 17065-1607

Mailing address

303 N Baltimore Ave
Mt Holly Springs, PA 17065-1607
Phone (717) 486-8550

Other identifiers 2

IdentifierTypeStateIssuer
1012907387OtherNPI
0010477270001MedicaidPA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20091211000072 PA Practitioner - Family PracticePractitioner - General SurgeryPractitioner - Geriatric Medicine 7315087087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD035872EPAMDGeriatric Medicine (Family Medicine) Physician

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, 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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1912907387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N BALTIMORE AVE",
            "city": "MT HOLLY SPRINGS",
            "state": "PA",
            "postal_code": "170651607",
            "telephone_number": "717-486-8550",
            "fax_number": "717-486-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N BALTIMORE AVE",
            "city": "MT HOLLY SPRINGS",
            "state": "PA",
            "postal_code": "170651607",
            "telephone_number": "717-486-8550",
            "fax_number": "717-486-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "MICHAEL",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD035872E",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD035872E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1012907387",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010477270001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly Springs, PA

Sources for this page

Verify at the official NPI Registry.