NICOLE ANN BLUETHGEN FNP, RN
NPI 1104701911
Nurse Practitioner - Family in Stony Brook, NY
About Nicole Ann Bluethgen Fnp, Rn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE ANN BLUETHGEN FNP, RN (NPI 1104701911) is an individual family provider in Stony Brook, New York, licensed in New York (357425) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS, is affiliated with Suny/stony Brook University Hospital, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Nicole Ann Bluethgen Fnp, Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Suny/Stony Brook University Hospital
Acute Care Hospitals · Stony Brook, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
STONY BROOK, NY 11794
STONY BROOK, NY 11794
STONY BROOK, NY 11794
STONY BROOK, NY 11794
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Nicole Bluethgen's NPI number?
The NPI number for Nicole Bluethgen is 1104701911. It was assigned to this individual provider in the NPPES registry on August 11, 2025.
Where is Nicole Bluethgen located?
Nicole Bluethgen practices at 101 Nicolls Rd, Stony Brook, NY 11794. The listed phone number is (631) 689-8333.
What is Nicole Bluethgen's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Nicole Bluethgen enrolled in Medicare?
Yes. Nicole Bluethgen is registered in the Medicare PECOS enrollment system.
Is Nicole Bluethgen affiliated with any hospitals?
According to CMS data, Nicole Bluethgen is affiliated with Suny/Stony Brook University Hospital.
When was this NPI record last updated?
The NPPES record for Nicole Bluethgen was last updated on August 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Nicole Ann Bluethgen, FNP, RN · NPI 1104701911
Family physician in Stony Brook, New York. Individual provider, active in the CMS NPPES registry since August 11, 2025.
## Identity
- **NPI:** 1104701911 (Entity type: Individual)
- **Enumerated:** August 11, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 357425 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 101 NICOLLS RD, Stony Brook, NY 11794-0001
- **Phone:** (631) 689-8333
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104701911) · Data from the CMS NPPES public registry.