Nicole Bettini, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00480900 Issued in NJ

Practice address

401 S Van Brunt St Ste 3
Englewood, NJ 07631-4600

Phone

(201) 569-2770

NPI assigned

Oct 17, 2016

Sex

Female

Sole proprietor

No

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 NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• New Jersey Orthopaedic Institute, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Wayne, NJ
  • NPI 1821224429
  Medicare reassignment

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1407307234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 VALLEY RD",
            "address_2": "STE 200",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S VAN BRUNT ST STE 3",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314600",
            "telephone_number": "201-569-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTINI",
        "first_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00480900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mary Bernard, FNP
• Lisa H Bernholz-Balsam, MS, CCC-SLP/A
• Ulrike Berth, M.D.
• Bessler Consulting LLC
• Joanne Betta, M.D.
• Betty Nursing Services/Home Care Inc.
• Madhuri Bewtra, M.D.
• Rajvi Prashant Bhagat, DDS
• Shreya Bhandari
• Heeruk Bhatt

• Physician Assistant in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.