NPIMap

Organization Active NPI

Amsterdam Orthopedics, Charles J Bertuch,Jr,MD,PC

Doing business as Charles J Bertuch, Jr, MD, PC

  • Specialist
  • Amsterdam, NY
National Provider Identifier
1003051905
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
99421-1 Issued in NY
Legal business name
AMSTERDAM ORTHOPEDICS, CHARLES J BERTUCH,JR,MD,PC
Doing business as
Charles J Bertuch, Jr, MD, PC
Practice address
124 Polar PLZ
Route 30 North
Amsterdam, NY 12010-1610
Phone
(518) 843-2292
Fax
(518) 843-1515
NPI assigned
Dec 5, 2008
Last updated
Dec 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Charles J Bertuch Jr., M.D.NPI 1316056013
Title
President
Phone
(518) 843-2292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 99421-1 NY Primary

Addresses

Primary practice location

124 Polar PLZ
Route 30 North
Amsterdam, NY 12010-1610

Mailing address

124 Polar PLZ
Route 30 North
Amsterdam, NY 12010-1610
Phone (518) 843-2292

Other identifiers 2

IdentifierTypeStateIssuer
0000CM0523OtherNYRAILROAD MEDICARE
00553493MedicaidNY

Other names 1

  • CHARLES J BERTUCH, JR, MD, PC Doing business as

National Provider Directory

National Provider Directory

Locations

124 Polar Plz
#30N
Amsterdam, NY 12010
Phone (518) 843-2292

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1003051905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 POLAR PLZ",
            "address_2": "ROUTE 30 NORTH",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101610",
            "telephone_number": "518-843-2292",
            "fax_number": "518-843-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 POLAR PLZ",
            "address_2": "ROUTE 30 NORTH",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101610",
            "telephone_number": "518-843-2292",
            "fax_number": "518-843-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMSTERDAM ORTHOPEDICS, CHARLES J BERTUCH,JR,MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "BERTUCH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-843-2292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "99421-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0000CM0523",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00553493",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHARLES J BERTUCH, JR, MD, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amsterdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.