Individual provider Active NPI

Karen Irinda Bertrand, MD

  • Family Medicine Physician
  • Cazenovia, NY
National Provider Identifier
1053566299
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
259421 Issued in NY
Practice address
132 1/2 Albany Street
Cazenovia, NY 13035
Phone
(315) 655-8171
Fax
(315) 655-5923
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 259421 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

132 1/2 Albany Street
Cazenovia, NY 13035

Mailing address

7647 Broadfield Road
Manlius, NY 13104
Phone (315) 247-3060

Other identifiers 1

IdentifierTypeStateIssuer
03461956MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120703000307 NY Practitioner - Family Practice 0042475774 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical PC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
St Josephs Hospital Health Center CurrentSince May 1, 2015 Accepting new patients
St Joseph'S Hospital Health Center Family Medicine CurrentSince May 1, 2015 Accepting new patients
North Medical PC Family Medicine Current Accepting new patients

Locations

132 Albany St
Ste 12
Cazenovia, NY 13035
Phone (315) 655-3668

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Rm 1605
Syracuse, NY 13203

Interoperability endpoints

  • Direct secure messaging: kbertrand122874@direct.upstate.edu

Organizations & group practices 4

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1053566299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7647 BROADFIELD ROAD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "13104",
            "telephone_number": "315-247-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 1/2 ALBANY STREET",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "13035",
            "telephone_number": "315-655-8171",
            "fax_number": "315-655-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAND",
        "first_name": "KAREN",
        "middle_name": "IRINDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "259421",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03461956",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cazenovia, NY

Sources for this page

Verify at the official NPI Registry.