NICOLE MARIE MCDANIEL (PT) – Specialist, NPI 1104826601

NICOLE MARIE MCDANIEL (PT) is a healthcare provider. based in Portland, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 5138 (OR). The NPI Number for NICOLE MARIE MCDANIEL (PT) is 1104826601

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE MARIE MCDANIEL (PT)
NPI
1104826601
Phone
(971) 258-0995
Address
530 NW 23RD AVE
Enumeration Date
26 July 2005
Last Update Date
20 February 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8665253175
Graduation Year
2001 (25 years ago)
PAC ID
3173906245
Group Practice PAC ID
5597178087
Professional Enrollment ID
I20220823001327
Address ID
OR971247844HI9620XDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

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Provider Addresses for NICOLE MARIE MCDANIEL (PT)

  • Nob Hill Psychic, 530, Northwest 23rd Avenue, Northwest District, Portland, Metro, Multnomah County, Oregon, 97210, United States

    SUITE #116

    PORTLAND, OR 972103287

    Phone: (971) 258-0995

    Fax: (844) 364-4344

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-08-23

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
I20220823001327IPhysical Therapist In Private PracticeORTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97210)

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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: 5597178087View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeOR

Reviews

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Frequently asked questions

How do payers reference NICOLE MARIE MCDANIEL (PT)?
For NICOLE MARIE MCDANIEL (PT), use NPI 1104826601 as the unique 10-digit identifier.
Active or inactive — what applies to NICOLE MARIE MCDANIEL (PT)?
You should see NICOLE MARIE MCDANIEL (PT) as active in CMS-hosted NPPES data.
What clinical focus is listed for NICOLE MARIE MCDANIEL (PT)?
At a glance, NICOLE MARIE MCDANIEL (PT) is tied to Other Service Providers. Clinical services aligned with this taxonomy classification.
What locale is associated with NICOLE MARIE MCDANIEL (PT)?
Directory geography for NICOLE MARIE MCDANIEL (PT) centers on Portland, Oregon.
Does NICOLE MARIE MCDANIEL (PT) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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