Ella Bergman, PA-C

Individual provider Active NPI Physician Assistant · Nutley, NJ

NPI 1932028701 · NPPES record last updated Jul 14, 2026

Key facts

NPI
1932028701
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
0110012037 (VA)
Practice address
123 Metro Blvd
Nutley, NJ 07110-6101
Phone
(973) 761-9000
NPI assigned
Jul 14, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110012037 VA Yes

Addresses

Primary practice location

123 Metro Blvd
Nutley, NJ 07110-6101

Mailing address

123 Metro Blvd
Nutley, NJ 07110-6101
Phone (973) 761-9000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 14, 2026.

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1932028701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 METRO BLVD",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071106101",
            "telephone_number": "973-761-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 METRO BLVD",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071106101",
            "telephone_number": "973-761-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "ELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110012037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

All providers in Nutley, NJ · Physician Assistant in New Jersey

Sources for this page

Verify at the official NPI Registry.