Individual provider Active NPI

Bindu Neupane Wagle

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1639701584
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ14982100 Issued in NJ
Practice address
500 Dekalb Ave
Brooklyn, NY 11205-5243
Phone
(718) 964-6161
NPI assigned
Feb 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71009772A IN
Adult Health Nurse Practitioner 363LA2200X 26NJ14982100 NJ Primary

Addresses

Primary practice location

500 Dekalb Ave
Brooklyn, NY 11205-5243

Mailing address

500 Dekalb Ave
Brooklyn, NY 11205-5243

Other practice location 1

5510 S East St Ste H
Indianapolis, IN 46227-1939
Phone (317) 924-8425

Other practice location 2

1701 N Senate Ave # Ago69
Indianapolis, IN 46202-5306
Phone (317) 962-5035

Other identifiers 1

IdentifierTypeStateIssuer
300046858MedicaidIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241211000929 NJ Practitioner - Nurse Practitioner 2466865019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essex Renal and Medical Group,LLCGroup PAC ID 5294708095, 5 clinicians

Practice addresses (Care Compare)

511 S Orange Ave
South Orange, NJ 07079-2636
Phone (973) 762-4720

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71009772AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC Nurse Practitioner CurrentSince Oct 6, 2024 Accepting new patients
Essex Renal & Medical Group,LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

101 Walnut St
Neptune City, NJ 07753
Phone (732) 774-2336

205 S Essex Ave
Orange, NJ 07050
Phone (973) 677-2800

511 S Orange Ave
South Orange, NJ 07079
Phone (973) 200-3600

250 Skillman St
Ste 202
Brooklyn, NY 11205

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1639701584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112055243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112055243",
            "telephone_number": "718-964-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5510 S East St Ste H",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462271939",
            "country_code": "US",
            "telephone_number": "317-924-8425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Ave # Ago69",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025306",
            "country_code": "US",
            "telephone_number": "317-962-5035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEUPANE WAGLE",
        "first_name": "BINDU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-09",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009772A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ14982100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300046858",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.