Individual provider Active NPI

Barbara Bertram, CRNA

  • Certified Registered Nurse Anesthetist
  • Wentzville, MO
National Provider Identifier
1245236504
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
053636 Issued in MO
Practice address
500 Medical Dr
Wentzville, MO 63385-3421
Phone
(636) 327-1362
NPI assigned
Jun 22, 2005
Last updated
May 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 053636 MO Primary

Addresses

Primary practice location

500 Medical Dr
Wentzville, MO 63385-3421

Mailing address

1324 Missouri Ave
Kirkwood, MO 63122-1018

Other identifiers 2

IdentifierTypeStateIssuer
918804204MedicaidMO
P00281582OtherMORR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000166 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113831561 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro-West Anesthesia Group IncGroup PAC ID 2163329921, 204 clinicians

Practice addresses (Care Compare)

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 453-0600

300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone (636) 947-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
053636MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dreamland Uap Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 19, 2021 Accepting new patients
Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2015 Accepting new patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2004 Accepting new patients
Ambulatory Anesthesia Services of St. Charles, LLC CurrentSince Jan 1, 2022 Accepting new patients
Washington University PastSince Jan 1, 1990 Accepting new patients

Locations

14825 North Outer 40 Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 898-4695

400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101

100 Village Sq
Hazelwood, MO 63042
Phone (314) 355-4010

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

4203 S Cloverleaf Dr
Saint Peters, MO 63376
Phone (636) 346-6051

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, 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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1245236504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 MISSOURI AVE",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853421",
            "telephone_number": "636-327-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "BARBARA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "053636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "918804204",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00281582",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.