Jennifer S. Beretsky, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

237317 Issued in NC

Practice address

2555 Court Dr Ste 450
Gastonia, NC 28054

Phone

(704) 671-7652

Fax

(704) 671-7656

NPI assigned

May 9, 2015

Last updated

Oct 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, CA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
• Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jberetsky95345@middlesexhealthprd.direct-ci.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.

• University of North Carolina at Chapel Hill

  dba UNC Faculty Physicians

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment NPD
• Caromont Medical Group Inc

  dba CaroMont Surgical Associates

  • Surgery Physician
  • Gastonia, NC
  • NPI 1972747053
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Surgery Physician
  • Eureka, CA
  • NPI 1477790517
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Caromont Medical Group, Inc.

  dba Carolinas Plastic Surgery Center

  • Plastic and Reconstructive Surgery Physician
  • Gastonia, NC
  • NPI 1720377625
  NPD (past)
• Park Ophthalmology

  • Ophthalmology Physician
  • Durham, NC
  • NPI 1619150141
  NPD (past)

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

• University of North Carolina Hospitals at Chapel Hill

  dba UNC Hospitals

  • General Acute Care Hospital
  • Chapel Hill, NC
  • NPI 1932208576
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Humboldt Home Infusion

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation

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

{
    "created_epoch": "1431129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1164800215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 450",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542191",
            "telephone_number": "704-671-7652",
            "fax_number": "704-671-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 450",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-671-7652",
            "fax_number": "704-671-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERETSKY",
        "first_name": "JENNIFER",
        "middle_name": "S.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-09",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007938",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R205065",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "237317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC",
            "identifier": "0397730007",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Hoffman Benoy, LMBT, MMP, CPMT
• Melissa Kelly Benson, LCSW, LCAS
• Karen B Bentley, M.D.
• Jean Lazenby Benton, FNP-C
• Mitchel Benton
• Kelly Marie Bergen, NP
• Nidia M Bermudez, MSW, LCSWA
• Vakesia Berrios, RN
• Wakiya Chanel Berry, AGNP-C
• Best Practice Homecare L.L.C

• Adult Health Nurse Practitioner in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.