NPIMap

Individual provider Active NPI

Nicole Bengel, PA-C

  • Physician Assistant
  • Wynnewood, PA
National Provider Identifier
1821461435
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057847 Issued in PA
Practice address
100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone
(484) 476-2826
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0001032 DE
Physician Assistant 363A00000X MA057847 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Mailing address

115 N Edgmont St
Media, PA 19063-3013
Phone (302) 530-8813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180626001315 PA Practitioner - Physician Assistant 5890070700 Reassigns benefits to 2 organizations
I20230802001687 CA Practitioner - Physician Assistant 5890070700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pennsylvania State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moran Rowen and Dorsey IncGroup PAC ID 9537063375, 35 clinicians
Radiology Associates of the Main Line P CGroup PAC ID 9931097193, 80 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
St Joseph Hospital
Orange, CA 92868-3891
Phone (714) 771-8171

154 Exton Square Mall
Exton, PA 19341-2440
Phone (484) 565-8590

Hospital & facility affiliations

  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Merit-based Incentive Payment System (MIPS)

Final score
84.56 of 100Reported as group
Quality
85.63
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61037CAMDClinical Social Worker
C5-0001032DEMDPhysician Assistant
MA057847PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Medical Specialists Association Past Accepting new patients
Main Line Health Imaging LP PastSince Dec 10, 2025 Accepting new patients
Bryn Mawr Medical Specialists Association PastSince Aug 17, 2025 Accepting new patients

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1821461435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N EDGMONT ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633013",
            "telephone_number": "302-530-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENGEL",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0001032",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.