NICOLE R BERMEJILLO
NPI 1417514779
Counselor - Professional in San Antonio, TX

Q: What is Nicole Bermejillo's NPI number?

The NPI number for Nicole Bermejillo is 1417514779. It was assigned to this individual provider in the NPPES registry on May 22, 2019.

Q: What is Nicole Bermejillo's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Bermejillo was last updated on November 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since May 22, 2019PECOS Enrolled

315 N SAN SABA STE 1003, SAN ANTONIO, TX 78207(210) 261-3100(210) 261-1821 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 6, 2023, Dec 12, 2022, May 22, 2019 (3 updates tracked since 2019).

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About Nicole R Bermejillo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE R BERMEJILLO (NPI 1417514779) is an individual professional provider in San Antonio, Texas, licensed in Texas (77924) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417514779

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameNICOLE R BERMEJILLO

Location Address315 N SAN SABA STE 1003San Antonio, TX 78207-3100

Mailing Address6800 Park Ten Blvd Ste 200sSan Antonio, TX 78213-4293 · (210) 261-1000 · Fax (210) 261-1821

Phone(210) 261-3100

Fax(210) 261-1821

Sole ProprietorNo

Enumeration DateMay 22, 2019

Last NPPES UpdateNovember 6, 20233 updates tracked since enumeration

NPPES CertifiedNovember 6, 2023

✔ NPI 1417514779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in TX · 77924

315 N SAN SABA STE 1003, San Antonio, TX 78207

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Molina Healthcare, Oscar Insurance Company.Insurance ›

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 R Bermejillo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLES NOLAN SPIVEY LPC

Counselor (Professional)