Nicole E Bellisario, DNP, PMHNP-BC, CNL

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95022579 Issued in CA

Practice address

402 W Broadway Ste 400
San Diego, CA 92101-3554

Phone

(888) 777-9409

Fax

(888) 999-6614

NPI assigned

Nov 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

Medicare fee-for-service enrollment

Enrolled in OR, NV2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  OR, Psychiatric/Mental Health

  Medicare reassignment NPD
• Lindsay L Wray PSYD Comprehensive Psychological Services PLLC

  • Psychologist
  • Henderson, NV
  • NPI 1619732385
  Medicare reassignment NPD
• Brave Care Institute, Inc.

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1285461228

  Psychiatric/Mental Health

  NPD Authorized official
• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819
  NPD (past)

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726358400000",
    "number": "1982172003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W BROADWAY STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013554",
            "telephone_number": "888-777-9409",
            "fax_number": "888-999-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W BROADWAY STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013554",
            "telephone_number": "888-777-9409",
            "fax_number": "888-999-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLISARIO",
        "first_name": "NICOLE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "DNP, PMHNP-BC, CNL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassidy Bellas
• Melisssa Jean Belle, DNP
• Joseph Bellezzo, M.D.
• Amy Lynn Bellinghausen, MD
• Mark Bellisario
• Alexandra Bellitter
• Bello Optometric Inc
• Adesuwa B Bello, DDS
• Danielle Bello, CCC-SLP
• Ruby L Bello, O.D.

• Psychiatric/Mental Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.