Nicolle A Bergin

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F309189-01 Issued in NY

Practice address

1231 Deer Park Ave
North Babylon, NY 11703-3104

Phone

(631) 667-0388

Fax

(631) 968-7705

NPI assigned

Jul 1, 2019

Last updated

Jul 1, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Long Island Comprehensive Medical Care PLLCGroup PAC ID 3678731908, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: nicolle.bergin@lcmc.eclinicaldirectplus.com

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.

• Long Island Comprehensive Medical Care PLLC

  • Internal Medicine Physician
  • North Babylon, NY
  • NPI 1043588536
  Medicare reassignment Care Compare group
• Lifelong Therapeutics OT PLLC

  • Physical Rehabilitation Occupational Therapist
  • Huntington Station, NY
  • NPI 1770850281
  NPD (past)
• Shahzad Iqbal Physician PLLC

  • Gastroenterology Physician
  • Queens Village, NY
  • NPI 1316331168
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1093377954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033104",
            "telephone_number": "631-667-0388",
            "fax_number": "631-968-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033104",
            "telephone_number": "631-667-0388",
            "fax_number": "631-968-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGIN",
        "first_name": "NICOLLE",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309189-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Bavaro
• Noor Afza Begum, D.O
• Lorraine Ivette Belevan
• Dionne Nicole Bennett, M.S.ED.
• Kimberly Berganza
• Irene Berketis
• Steven B Berkowitz, RPH
• Vladymir Melanie Bernier, LPN
• Kayla Berretta
• Melissa Berrick, OTR/L

• Adult Health Nurse Practitioner in North Babylon, NY
• Providers in North Babylon, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.