Nicole Bobbio-Hertog, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

028659 Issued in NY

Practice address

43 New Scotland Ave # MC-139
Albany, NY 12208-3478

Phone

(518) 262-3131

NPI assigned

Aug 11, 2022

Last updated

Aug 11, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Practice roles

Locations

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.

• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1770823791
  Medicare reassignment
• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment
• Albany Medical College

  dba Albany Medical College Department of Medicine

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248

  Physician Assistant

  NPD
• Multicare Health System

  dba Mary Bridge Emergency Dept

  • Pediatrics Physician
  • Tacoma, WA
  • NPI 1093768194
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1073854766
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Winslow Clinic

  • Family Medicine Physician
  • Bainbridge Island, WA
  • NPI 1730237942
  NPD
• Virginia Mason Medical Center

  dba St Joseph Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1447988951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 VICTORIA LN APT G",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120542444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 NEW SCOTLAND AVE # MC-139",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083478",
            "telephone_number": "518-262-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBIO-HERTOG",
        "first_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy James Bloom, D.C.
• Blooming Tree, LLC
• Blue Chip Medical LLC
• Blue Flower Counseling LCSW, PLLC
• Bluebridge Medical Inc
• Cassidy Bobeck
• Lori A Bobersky, LMSW
• Amanda Lynn Boccio, D.C.
• Ryan Patrick Bochacki, MD
• Jeremy Bodie-Bromberg

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.