Individual provider Active NPI

Richard Berthelot

  • Home Health Aide
  • St Petersburg, FL
National Provider Identifier
1033795265
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
253Z00000X Issued in FL
Practice address
2521 Madrid Way S
St Petersburg, FL 33712-3933
Phone
(727) 642-5448
NPI assigned
Mar 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 253Z00000X FL Primary

Addresses

Primary practice location

2521 Madrid Way S
St Petersburg, FL 33712-3933

Mailing address

2521 Madrid Way S
St Petersburg, FL 33712-3933
Phone (727) 642-5448

Other identifiers 1

IdentifierTypeStateIssuer
1447602024OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
253Z00000XFLMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Bystenia Services Inc PastSince Mar 21, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1033795265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 MADRID WAY S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337123933",
            "telephone_number": "727-642-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 MADRID WAY S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337123933",
            "telephone_number": "727-642-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTHELOT",
        "first_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": "253Z00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447602024",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.