Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Conrad Joseph Daniel

Individual provider Physician Assistant · NPI 1598449860

Conrad Joseph Daniel is a Physician Assistant in Indianapolis, Indiana. Qualified in 2023, 3 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and Oregon.

Years since qualifying
3
Licensed in
IN, OR
In the registry since
2023
Specialties on file
3
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Practice location Address checks out

1230 E Cragmont Dr
Indianapolis, IN 46227-4834
Phone: (317) 437-9880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 19250 Sw 65th Ave Ste 200, Tualatin, OR 97062-7707 — (503) 413-2005

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA224057 (OR)
Physician Assistant Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 10004307A (IN)

Record details

NPI number1598449860
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 14, 2023
Last updated in NPPESMay 6, 2025
Certification dateMay 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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