Individual provider Active NPI

Michelle Bertman, LSW

  • Social Worker
  • Mentor, OH
National Provider Identifier
1144500703
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.0800894 Issued in OH
Practice address
9083 Mentor Ave
Mentor, OH 44060-6462
Phone
(440) 205-2674
NPI assigned
Aug 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.0800894 OH Primary

Addresses

Primary practice location

9083 Mentor Ave
Mentor, OH 44060-6462

Mailing address

9083 Mentor Ave
Mentor, OH 44060-6462
Phone (440) 205-2674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20160524000841 OH Practitioner - Clinical Social Worker 7113216516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Charities CorporationGroup PAC ID 6608866546, 12 clinicians

Practice addresses (Care Compare)

140 Richmond Rd
Euclid, OH 44143-1239
Phone (800) 860-7373

6753 State Rd
Parma, OH 44134-4517
Phone (800) 860-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.0800894OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Corporation Current Accepting new patients

Locations

7911 Detroit Ave
Cleveland, OH 44102
Phone (216) 334-2876

1515 W 29th St
Cleveland, OH 44113
Phone (216) 574-9000

Organizations & group practices 1

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": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1144500703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9083 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606462",
            "telephone_number": "440-205-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9083 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606462",
            "telephone_number": "440-205-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTMAN",
        "first_name": "MICHELLE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0800894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.