Individual provider Active NPI

Gabriella Berta

  • Family Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1407247752
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33 339390 Issued in NY
Practice address
15 Fulton Ave
# LL
Poughkeepsie, NY 12603
Phone
(845) 473-8996
Fax
(845) 473-8997
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 33 339390 NY Primary

Addresses

Primary practice location

15 Fulton Ave
# LL
Poughkeepsie, NY 12603

Mailing address

15 Fulton Ave
# LL
Poughkeepsie, NY 12603-2315
Phone (845) 562-2191

Other identifiers 1

IdentifierTypeStateIssuer
041845439MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160316001261 NY Practitioner - Nurse Practitioner 3971809070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19 Bradhurst Ave
Suite 3040N
Hawthorne, NY 10532-2180
Phone (914) 909-4168

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
33 339390NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Feb 1, 2024 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Feb 1, 2024 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3040N
Hawthorne, NY 10532
Phone (914) 493-2363

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1407247752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FULTON AVE",
            "address_2": "# LL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032315",
            "telephone_number": "845-562-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FULTON AVE",
            "address_2": "# LL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "telephone_number": "845-473-8996",
            "fax_number": "845-473-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTA",
        "first_name": "GABRIELLA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33 339390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041845439",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.