Samuel T Bertsos, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.007614RX Issued in OH

Practice address

2835 Miami Village Dr
Miamisburg, OH 45342-4916

Phone

(937) 354-3700

Fax

(937) 262-7468

NPI assigned

Apr 5, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Orthopaedics and Sports Medicine LTDGroup PAC ID 0345136412, 471 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.bertsos.p1@direct.beaconortho.nextgenshare.com

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.

• Beacon Orthopaedics & Sports Medicine, LTD

  • Specialist
  • Cincinnati, OH
  • NPI 1386670065

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Beacon Orthopaedics & Sports Medicine LTD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Worthington, OH
  • NPI 1699472878
  NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1114668928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE STE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 MIAMI VILLAGE DR",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453424916",
            "telephone_number": "937-354-3700",
            "fax_number": "937-262-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSOS",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007614RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Behavior and Sleep Medicine LLC
• Ellen Belbeck
• Benevolent Home Care LLC
• Daniel Willie Benson Sr.
• Ashley Berg
• Kishley Bhalla, MD
• Deborah Lynn Biggs, RN
• Chelsea Leann Birkemeier, MSN, APRN, PMHNP-BC
• Claire Umwali Bisengimana
• Brianna Bittorf, RBT

• Physician Assistant in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.