Individual provider Active NPI

Vicki Marie Bertka, M.D.

  • Family Medicine Physician
  • Perrysburg, OH
National Provider Identifier
1184618746
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-050009 Issued in OH
Practice address
30000 E River Rd
Perrysburg, OH 43551-3429
Phone
(419) 661-4001
NPI assigned
Sep 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-050009 OH Primary
Family Medicine Physician 207Q00000X 4301084923 MI

Addresses

Primary practice location

30000 E River Rd
Perrysburg, OH 43551-3429

Mailing address

30000 E River Rd
Perrysburg, OH 43551-3429
Phone (419) 661-4001

Other names 1

  • Dr. Vicki Marie Taylor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20171127002370 PA Practitioner - Hospice/Palliative Care 8628216215 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084923MIMDFamily Medicine Physician
35-050009OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Nov 5, 2017 Accepting new patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Nov 5, 2017 Accepting new patients
Hospice of Northwest Ohio Family Medicine Past Accepting new patients
Hospice of Northwest Ohio PastSince Jun 26, 2011 Accepting new patients

Locations

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 5

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1184618746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30000 E RIVER RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513429",
            "telephone_number": "419-661-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30000 E RIVER RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513429",
            "telephone_number": "419-661-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTKA",
        "first_name": "VICKI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-050009",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301084923",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "TAYLOR",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.