Nicole Lee Bentley, M.D.
Individual provider Active NPI Pediatrics Physician · Cedar Falls, IA
NPI 1629423967 · NPPES record last updated Jun 30, 2019
Key facts
- NPI
- 1629423967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD-46258 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191001002251 | IA | Practitioner - Pediatric Medicine | 6204129356 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-46258 | IA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Physicians Clinic Medical Foundation | Pediatrics | Current |
Accepting new patients |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Allen Memorial Hospital Corporation | Past | Accepting new patients | |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Locations
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950
Interoperability endpoints
- nbentley410973@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 68391-20 | WI | |
| Pediatrics Physician | 208000000X | MD-46258 | IA | Yes |
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
- Nicole Lee Goodale
Other providers in Cedar Falls, IA
- Cathryn Baumgartner
- Gary Beetner
- Cameron James Belgio
- Derrick James Benner
- Rachel Helen Benson
- Berendzen Mental Health Services, LLC
- Jenna Zalk Berendzen
- Bethesda Group Home and Staffing Agency LLC
- Bijelic Counseling and Consulting Services LLC
- Ljubomirka Bijelic-Appenzeller
All providers in Cedar Falls, IA · Pediatrics Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.