Individual provider Active NPI

Carmen Bertino, PT

  • Physical Therapist
  • Rochester, NY
National Provider Identifier
1104204148
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011305-1 Issued in NY
Practice address
2050 Clinton Ave S
Rochester, NY 14618-5727
Phone
(585) 720-9608
NPI assigned
May 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 011305-1 NY Primary

Addresses

Primary practice location

2050 Clinton Ave S
Rochester, NY 14618-5727

Mailing address

3256 Canoga St
Seneca Falls, NY 13148-9553
Phone (585) 720-9608

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
011305NYMDOptometrist
011305-1NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stern at Home Physical Therapy PC Physical Therapist CurrentSince Jul 14, 2024 Accepting new patients
Finger Lakes United Cerebral Palsy, Inc. Past Accepting new patients

Locations

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

Organizations & group practices 2

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1104204148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3256 CANOGA ST",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131489553",
            "telephone_number": "585-720-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185727",
            "telephone_number": "585-720-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTINO",
        "first_name": "CARMEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "011305-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.