DANIELLE NICOLE BEDORE (PA-C) – Physician Assistant, NPI 1124363387

DANIELLE NICOLE BEDORE (PA-C) is a healthcare provider. based in Tulsa, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 15-02336 (KS). The NPI Number for DANIELLE NICOLE BEDORE (PA-C) is 1124363387

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
DANIELLE NICOLE BEDORE (PA-C)
NPI
1124363387
Phone
(918) 574-0250
Address
9245 S MINGO RD
Enumeration Date
29 November 2012
Last Update Date
8 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7857763322
Graduation Year
2012 (14 years ago)
PAC ID
9830336866
Group Practice PAC ID
2860303427
Professional Enrollment ID
I20200616001839
Address ID
KS665023381MA1823XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,303 PHYSICIAN ASSISTANT in KS

Provider Addresses for DANIELLE NICOLE BEDORE (PA-C)

  • 9245 S MINGO RD

    TULSA, OK 741335793

    Phone: (918) 574-0250

    Fax: (918) 574-0259

    Type: Mailing

  • 3700 ROCKY FORD AVE

    MANHATTAN, KS 665027230

    Phone: (785) 238-1391

    Fax: (785) 238-3160

    Type: Location

  • 1823 COLLEGE AVE

    MANHATTAN, KS 665023381

    Phone: (785) 323-6300

    Fax: (785) 587-5486

    Type: Location

  • 1133 COLLEGE AVE

    MANHATTAN, KS 665022770

    Phone: (785) 323-6006

    Fax: (785) 323-6010

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $45.

Total Amount is formed as General ($45) + Research ($0) + Ownership ($0) = $45.

Last reported payment date: 2024-10-11 • Largest payer in this snapshot: CSL Behring ($31).

Total Amount

$45

General + Research + Ownership

Payments

2

Total payment records

General Amount

$45

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200616001839IPhysician AssistantKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
27447Replacement of knee joint, both sides of knee1614$0
99213Established patient office or other outpatient visit, 20-29 minutes1412$0
View full utilization report →

Insurance plans in this area (ZIP 74133)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860303427View full group profile
NameSpecialtyState
Physician AssistantKS
-KS
-KS
Hospitalist, Internal MedicineLA
Physical Medicine And Rehabilitation, Sports MedicineMO
Physician AssistantKS
Cardiovascular Disease (Cardiology), Internal MedicineAL
Physician AssistantKS
Internal Medicine, Pediatric MedicineKS
Nurse PractitionerKS

Reviews

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Frequently asked questions

How is DANIELLE NICOLE BEDORE (PA-C) identified in CMS data?
CMS-hosted NPPES data lists DANIELLE NICOLE BEDORE (PA-C) with NPI 1124363387.
Is DANIELLE NICOLE BEDORE (PA-C) still practicing?
DANIELLE NICOLE BEDORE (PA-C) is currently listed as active in the public NPI registry.
What is DANIELLE NICOLE BEDORE (PA-C)'s primary classification?
Physician Assistant is the headline specialty for DANIELLE NICOLE BEDORE (PA-C) here. Clinical services aligned with this taxonomy classification.
Where is DANIELLE NICOLE BEDORE (PA-C) based?
DANIELLE NICOLE BEDORE (PA-C) is tied to Tulsa, Oklahoma in the data we show; additional addresses may exist on the full record.
Is the information about DANIELLE NICOLE BEDORE (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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