Individual provider Active NPI

Chad Bertucci, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Muskegon, MI
National Provider Identifier
1205155710
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301096254 Issued in MI
Practice address
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone
(231) 728-5758
NPI assigned
May 24, 2010
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301096254 MI Primary

Addresses

Primary practice location

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Mailing address

PO Box 26
Muskegon, MI 49443-0026
Phone (231) 728-5758

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Chad.Bertucci@trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150518001502 MI Practitioner - Pathology 1850524356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westshore Diagnostics, PCGroup PAC ID 4789748906, 6 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 728-5758

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301096254MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westshore Diagnostics, PC CurrentSince Jul 8, 2015 Accepting new patients

Locations

10 Little Brook Rd
West Wareham, MA 02576

1309 Sheldon Rd
Grand Haven, MI 49417
Phone (616) 842-3600

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

1774 Peck St
Muskegon, MI 49441
Phone (231) 722-6768

3104 Henry St
Norton Shores, MI 49441

Interoperability endpoints

  • Direct secure messaging: chad.bertucci@trinity-health.org

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

Hospital & facility affiliations 3

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": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1205155710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494430026",
            "telephone_number": "231-728-5758",
            "fax_number": "231-728-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-728-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTUCCI",
        "first_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301096254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Chad.Bertucci@trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Muskegon MI Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1500 E Sherman Blvd",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.