Individual provider Active NPI

Berta Leisy Stroud, MD

  • Anesthesiology Physician
  • Cleveland, OH
National Provider Identifier
1013395367
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01083247A Issued in IN
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 444-0660
Fax
(216) 444-7360
NPI assigned
May 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01083247A IN Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

PO Box 1332
Bloomington, IN 47402-1332
Phone (812) 345-8188

Other practice location 1

1402 S Grand Blvd
M260
Saint Louis, MO 63104-1004
Phone (314) 977-9853

Other names 1

  • Berta Leisy Cerro Gomez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200616001392 IN Practitioner - Anesthesiology 3870895261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomington Anesthesiologists PCGroup PAC ID 6204740988, 39 clinicians

Practice addresses (Care Compare)

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9147

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01083247AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bloomington Anesthesiologists PC Anesthesiology CurrentSince Jul 1, 2020 Accepting new patients

Locations

445 S Landmark Ave
Bloomington, IN 47403
Phone (812) 353-3450

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

4011 S Monroe Medical Park Blvd
Bloomington, IN 47403
Phone (812) 825-5777

2800 Rex Grossman Blvd
Bloomington, IN 47403
Phone (800) 841-4938

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

2425 Northpark Dr
Ste 20
Columbus, IN 47203
Phone (812) 657-7800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1013395367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1332",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021332",
            "telephone_number": "812-345-8188",
            "fax_number": "844-338-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-0660",
            "fax_number": "216-444-7360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 S Grand Blvd",
            "address_2": "M260",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041004",
            "country_code": "US",
            "telephone_number": "314-977-9853",
            "fax_number": "314-977-9852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STROUD",
        "first_name": "BERTA",
        "middle_name": "LEISY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01083247A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERTA",
            "last_name": "CERRO GOMEZ",
            "middle_name": "LEISY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.