Individual provider Active NPI

Michael Bertino, M.D.

  • Otolaryngology Physician
  • San Antonio, TX
National Provider Identifier
1114921020
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D4928 Issued in TX
Practice address
21 Spurs LN Ste 310
San Antonio, TX 78240-1679
Phone
(210) 615-8332
NPI assigned
Jun 8, 2005
Last updated
Jan 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D4928 TX Primary

Addresses

Primary practice location

21 Spurs LN Ste 310
San Antonio, TX 78240-1679

Mailing address

10740 N Gessner Rd Ste 310
Houston, TX 77064-1240
Phone (281) 897-0416

Other practice location 1

4775 Hamilton Wolfe Rd
Bldg 1
San Antonio, TX 78229-3463
Phone (210) 616-0283 ext. 2114

Other identifiers 1

IdentifierTypeStateIssuer
135493803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100121000350 TX Practitioner - Otolaryngology 3678504826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Southwestern Medical School at Dallas, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ear, Nose and Throat Specialists, PLLCGroup PAC ID 5799770202, 123 clinicians

Practice addresses (Care Compare)

21 Spurs LN
Suite 310
San Antonio, TX 78240-1679
Phone (210) 615-8332

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.75 of 100Reported as group
Promoting interoperability
95
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ear, Nose & Throat Specialists, PLLC Otolaryngology CurrentSince Aug 25, 2023 Accepting new patients
Noble Anesthesia Partners, PLLC Past Accepting new patients

Locations

10740 N Gessner Rd
Ste 310
Houston, TX 77064
Phone (281) 897-0416

18707 Hardy Oak Blvd
Ste 475
San Antonio, TX 78258
Phone (210) 249-4858

21 Spurs Ln
Ste 310
San Antonio, TX 78240
Phone (210) 558-7025

4775 Hamilton Wolfe Rd
Ste 1
San Antonio, TX 78229
Phone (210) 616-0283

9301 Pinecroft Dr
Ste 150
Shenandoah, TX 77380
Phone (281) 362-1368

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1114921020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 N GESSNER RD STE 310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641240",
            "telephone_number": "281-897-0416",
            "fax_number": "800-346-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 310",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401679",
            "telephone_number": "210-615-8332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4775 Hamilton Wolfe Rd",
            "address_2": "Bldg 1",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293463",
            "country_code": "US",
            "telephone_number": "210-616-0283 x2114",
            "fax_number": "210-616-0071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTINO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "D4928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135493803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.