Individual provider Active NPI

Rebecca Jean Pullen, FNP, CNM

  • Family Nurse Practitioner
  • Houghton, NY
National Provider Identifier
1891138988
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337900 Issued in NY
Practice address
9663 Route 19
Houghton, NY 14744-8736
Phone
(478) 396-6469
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 001539 NY
Family Nurse Practitioner 363LF0000X 337900 NY Primary

Addresses

Primary practice location

9663 Route 19
Houghton, NY 14744-8736

Mailing address

9663 Route 19
Houghton, NY 14744-8736
Phone (478) 396-6469

Other identifiers 1

IdentifierTypeStateIssuer
3599048MedicaidNY

Other names 1

  • Rebecca Jean Beardsley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150521000089 NY Practitioner - Nurse Practitioner 9830419563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sleep Reset Medical Group of New Jersey PCGroup PAC ID 9234651142, 3 clinicians

Practice addresses (Care Compare)

169 Madison Ave
New York, NY 10016-5101
Phone (862) 235-4743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
001539NYMDArt Therapist
337900NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Reset Medical Group of New Jersey PC CurrentSince Jul 17, 2025 Accepting new patients
Medical Associates of Englewood, PC PastSince Jul 17, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

169 Madison Ave
Ste 15069
New York, NY 10016

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1891138988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9663 ROUTE 19",
            "city": "HOUGHTON",
            "state": "NY",
            "postal_code": "147448736",
            "telephone_number": "478-396-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9663 ROUTE 19",
            "city": "HOUGHTON",
            "state": "NY",
            "postal_code": "147448736",
            "telephone_number": "478-396-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "credential": "FNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "001539",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3599048",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BEARDSLEY",
            "middle_name": "JEAN",
            "credential": "FNP, CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houghton, NY

Sources for this page

Verify at the official NPI Registry.