Salvatore Bertucci

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101023685 Issued in MI

Practice address

36000 Darnall Loop
Fort Hood, TX 76544-5095

Phone

(254) 288-8234

NPI assigned

Jun 30, 2015

Last updated

Feb 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1043693716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445095",
            "telephone_number": "254-288-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTUCCI",
        "first_name": "SALVATORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "MI",
            "license": "5101023685",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101023685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Mercedes Bermudez, R.N
• Gary Marie Bernard, APRN
• Phillip Andrew Berntson, PA-C
• Nytashia Berrian, ARNP, WHNP
• Mechelle Berry
• Kaitlin Alissa Bettencourt, M.D
• Veena Bhalla, CSW
• Linda Ann Bibbee, RN
• Annabel Bibilari, PA-C
• Zachary Douglas Bice, PA-C

• General Practice Physician in Fort Hood, TX
• Providers in Fort Hood, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.