Nicole Bertolino Bourne, OTR/L in Wake Forest, NC - Medicare Occupational Therapist Provider

Nicole Bertolino Bourne, OTR/L is a medicare enrolled "Occupational Therapist" provider in Wake Forest, North Carolina. Her current practice location is 900 S Franklin St Ste 201, Wake Forest, North Carolina. You can reach out to her office (for appointments etc.) via phone at (973) 567-1913.

Nicole Bertolino Bourne is licensed to practice in South Carolina (license number 5469) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1356809925.

Contact Information

	Nicole Bertolino Bourne, OTR/L
	900 S Franklin St Ste 201, Wake Forest, NC 27587-2799
	(973) 567-1913
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nicole Bertolino Bourne
Gender	Female
Speciality	Occupational Therapist
Location	900 S Franklin St Ste 201, Wake Forest, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356809925
Provider Enumeration Date: 03/03/2019
Last Update Date: 03/30/2023

Medicare PECOS Information:

PECOS PAC ID: 9931574514
Enrollment ID: I20230413000093

Medical Identifiers

Medical identifiers for Nicole Bertolino Bourne such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356809925	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	14379 (North Carolina)	Secondary
225X00000X	Occupational Therapist	5469 (South Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicole Bertolino Bourne allows following entities to bill medicare on her behalf.

Provider Name	Peak Performance Sports And Physical Therapy Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1194714063 PECOS PAC ID: 0749276426 Enrollment ID: O20040421000043

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Bertolino Bourne is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Nicole Bertolino Bourne, OTR/L 900 S Franklin St Ste 201, Wake Forest, NC 27587-2799 Ph: (919) 556-1700	Nicole Bertolino Bourne, OTR/L 900 S Franklin St Ste 201, Wake Forest, NC 27587-2799 Ph: (973) 567-1913

Reviews and Comments

Occupational Therapist in Wake Forest, NC

Kerri Maria Watkins, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 616 Dr Calvin Jones Hwy Ste 212, Wake Forest, NC 27587 Phone: 919-673-4246
Stephanie Nicole Biggs Ayers, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 701 Tree Green Ln, Wake Forest, NC 27587 Phone: 919-717-0245
Angela Abbott, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 S Franklin St Ste 201, Wake Forest, NC 27587 Phone: 919-556-1700 Fax: 919-556-1245
Kaitlyn Schafer, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 900 S Franklin St Ste 201, Wake Forest, NC 27587 Phone: 919-556-1245
Ms. Rae-lynn Ziegler, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 956 Jones Wynd, Wake Forest, NC 27587 Phone: 919-274-0123
Angela Moore, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 7204 Donneeford Rd, Wake Forest, NC 27587 Phone: 919-539-3779
Mrs. Jennifer L Brown, MS, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 S Franklin St, Wake Forest, NC 27587 Phone: 919-556-1700

Nicole Bertolino Bourne, OTR/L - Medicare Occupational Therapist in Wake Forest, NC