Jian Xin Bertolino, AGPCNP/BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F308582-1 Issued in NY

Practice address

5620 Main St
Flushing, NY 11355-5046

Phone

(718) 670-1837

Fax

(718) 961-1853

NPI assigned

Mar 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jianxinbertolino@nslijmedgr.allscriptsdirect.net

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.

• New York Queens Medicine and Surgery, P.C.

  • Pediatrics Physician
  • Fresh Meadows, NY
  • NPI 1003114851
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• New York Queens Medicine and Surgery, P.C.

  • Multi-Specialty Clinic/Center
  • Flushing, NY
  • NPI 1740792233
  NPD

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1922500982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555046",
            "telephone_number": "718-670-1837",
            "fax_number": "718-961-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555046",
            "telephone_number": "718-670-1837",
            "fax_number": "718-961-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLINO",
        "first_name": "JIAN XIN",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP/BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F308582-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05133835",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Thomas Bernard, DNP, CRNA
• Maggie Bernholz Berenholtz
• Lisa Bernstein
• Zoe Leigh Bernstein
• Dino D. Berruti, PA
• Best Care Medical Supplies Inc
• Best Care Medicine PLLC
• Best Care RX LLC
• Best Counsel LLC
• Best Health Group 26 Inc

• Primary Care Nurse Practitioner in Flushing, NY
• Providers in Flushing, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.