NICOLE RENGIFO – Adult Health Nurse Practitioner, NPI 1104366699

NICOLE RENGIFO is a healthcare provider. based in Roselle, New Jersey. specializing in NURSE PRACTITIONER. They hold a License No. 26NJ00714000 (NJ). The NPI Number for NICOLE RENGIFO is 1104366699

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE RENGIFO
NPI
1104366699
Phone
Not provided
Address
227 E 3RD AVE
Enumeration Date
2 March 2017
Last Update Date
2 March 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2012276050
Graduation Year
2016 (10 years ago)
PAC ID
7416291596
Group Practice PAC ID
4284647868
Professional Enrollment ID
I20181129002802
Address ID
NJ076664245TE718XXRDXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:9State licenses:1Digital endpointsOther names

7,515 NURSE PRACTITIONER in NJ

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Provider Addresses for NICOLE RENGIFO

  • 227, East 3rd Avenue, Roselle, Union County, New Jersey, 07203, United States

    ROSELLE, NJ 072031333

    Phone:

    Type: Mailing

  • Holy Name Medical Center, 718, Teaneck Road, Teaneck Township, Bergen County, New Jersey, 07666, United States

    TEANECK, NJ 076664245

    Phone: (201) 833-3000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-11-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181129002802INurse PractitionerNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99212Established patient office or other outpatient visit, 10-19 minutes8564$0
99211Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional6644$0
99457Management using the results of remote vital sign monitoring per calendar month, first 20 minutes6348$0
99442Telephone medical discussion with physician, 11-20 minutes2911$0
99441Telephone medical discussion with physician, 5-10 minutes2715$0
View full utilization report →

Insurance plans in this area (ZIP 07203)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284647868View full group profile

Reviews

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Frequently asked questions

What is the registry number for NICOLE RENGIFO?
The registry entry for NICOLE RENGIFO shows NPI 1104366699.
Does the public listing show NICOLE RENGIFO as active?
NICOLE RENGIFO's NPI record reflects an active status in NPPES.
How should patients interpret NICOLE RENGIFO's specialty?
The extract shows Adult Health Nurse Practitioner for NICOLE RENGIFO. Clinical services aligned with this taxonomy classification.
What city is tied to NICOLE RENGIFO?
The directory associates NICOLE RENGIFO with Roselle, New Jersey. Check all listed addresses for suites or satellite offices.
Can I export NICOLE RENGIFO's record?
You can download the official NPPES record; we summarize key fields for readability.

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