Individual provider Active NPI

Nicole Lee Bentley, M.D.

  • Pediatrics Physician
  • Cedar Falls, IA
National Provider Identifier
1629423967
Registry record updated Jun 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-46258 Issued in IA
Practice address
5100 Prairie Pkwy Ste 203
Cedar Falls, IA 50613
Phone
(319) 222-2903
Fax
(319) 222-2993
NPI assigned
Apr 24, 2016
Last updated
Jun 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 68391-20 WI
Pediatrics Physician 208000000X MD-46258 IA Primary

Addresses

Primary practice location

5100 Prairie Pkwy Ste 203
Cedar Falls, IA 50613

Mailing address

5100 Prairie Pkwy Ste 203
Cedar Falls, IA 50613-8155
Phone (319) 222-2903

Other practice location 1

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Other practice location 2

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Other names 1

  • Nicole Lee Goodale Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191001002251 IA Practitioner - Pediatric Medicine 6204129356 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Pediatrics CurrentSince Sep 9, 2019 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

Interoperability endpoints

  • Direct secure messaging: nbentley410973@direct.unitypoint.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561852800000",
    "number": "1629423967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 PRAIRIE PKWY STE 203",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506138155",
            "telephone_number": "319-222-2903",
            "fax_number": "319-222-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 PRAIRIE PKWY STE 203",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "50613",
            "telephone_number": "319-222-2903",
            "fax_number": "319-222-2993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-24",
        "last_updated": "2019-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "68391-20",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-46258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GOODALE",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cedar Falls, IA

Sources for this page

Verify at the official NPI Registry.