Jennifer S Bertapelle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4037 Issued in OR

Practice address

4605 NE Fremont St Ste 210
Portland, OR 97213-1715

Phone

(503) 504-3181

NPI assigned

Jun 15, 2007

Last updated

Mar 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in OR

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527
  Medicare reassignment

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1144425638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 NE REGENTS DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121660",
            "telephone_number": "971-275-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 NE FREMONT ST STE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131715",
            "telephone_number": "503-504-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTAPELLE",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Bershaw, CRNA
• Alexandra Jae Bershon
• Sara C Bersi Armstrong, LMT
• Joe Louis Bertagnolli, LCSW
• Marcia Bertalot, ANP
• Bertik Chiropractic Enterprises, LLC (Portland Center for Spinal Correction)
• Josi L Bertling, LMT
• James Mark Bertola
• Andrea Marie Bertoni, PHARMD
• Elvira Bertrand

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.