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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
{
"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
- Victoria L Beckerman
- Jared Beerman
- Behavioral Health Associates of New Jersey LLC
- Brianna Benton
- Bergen Orthopedic and Sports Medicine
- David L Berkovitz
- Amanda Berman Levy
- Farid Beshay
- Christine Bilello
- Bilingual Total Wellness LLC
All providers in Nutley, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.