Edward John Bertaccini, MD

Primary specialty

Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X

License

G71364 Issued in CA

Practice address

3801 Miranda Ave
Dept. of Anesthesia, 112a, Palo Alto VA Hospital
Palo Alto, CA 94304-1207

Phone

(650) 493-5000

Fax

(650) 852-3423

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By 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 1

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063432623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "address_2": "DEPT. OF ANESTHESIA, 112A, PALO ALTO VA HOSPITAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041207",
            "telephone_number": "650-493-5000",
            "fax_number": "650-852-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "address_2": "DEPT. OF ANESTHESIA, 112A, PALO ALTO VA HOSPITAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041207",
            "telephone_number": "650-493-5000",
            "fax_number": "650-852-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTACCINI",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "CA",
            "license": "G71364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Berry, FNP
• Julia Elizabeth Berry
• Mark Francis Berry, MD
• Rebecca Rialon Berry, PH.D.
• Janine Berta, MS, RD-AP, CNSC
• Alice Bertaina, MD, PHD
• Diana Kimberly Berthil, DPT
• Anthony Bertrand
• Denise Angelica Berumen
• Hannah Grace Beskind, PA-C

• Critical Care Medicine (Anesthesiology) Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Critical Care Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.