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

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 NameNicole Bertolino Bourne
GenderFemale
SpecialityOccupational Therapist
Location900 S Franklin St Ste 201, Wake Forest, North Carolina
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1356809925NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 14379 (North Carolina)Secondary
225X00000XOccupational 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 NamePeak Performance Sports And Physical Therapy Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI 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 AddressPractice 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    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.