Individual provider Active NPI

Jeremy Paul Bertocchi

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1275340796
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15138 Issued in NC
Practice address
116 Northridge Dr
Pittsburgh, PA 15237-2002
Phone
(412) 491-8812
NPI assigned
Dec 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 0010-15138 NC Primary

Addresses

Primary practice location

116 Northridge Dr
Pittsburgh, PA 15237-2002

Mailing address

116 Northridge Dr
Pittsburgh, PA 15237-2002
Phone (412) 491-8812

Other practice location 1

653 Bluefield Rd Ste A
Mooresville, NC 28117-9626
Phone (704) 360-6460

Other practice location 2

1540 E Broad St
Statesville, NC 28625-4302
Phone (704) 380-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415001595 NC Practitioner - Physician Assistant 1658896410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

Statesville, NC 28677
Phone (704) 838-2182

1540 E Broad St
Statesville, NC 28625-4302

728 Hartness Rd
Statesville, NC 28677-3425
Phone (704) 380-6420

766 Hartness Rd
Suite B
Statesville, NC 28677-3479

Hospital & facility affiliations

  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-15138NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Physician Network LLC CurrentSince May 5, 2025 Accepting new patients
Iredell Physician Network LLC CurrentSince May 5, 2025 Accepting new patients
Iredell Physician Network, LLC PastSince Mar 26, 2023 Accepting new patients
Iredell Physician Network LLC Past Accepting new patients

Locations

653 Bluefield Rd
Ste A
Mooresville, NC 28117
Phone (704) 360-6460

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

766 Hartness Rd
Ste B
Statesville, NC 28677

1540 E Broad St
Statesville, NC 28625
Phone (704) 230-4382

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1275340796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 NORTHRIDGE DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152372002",
            "telephone_number": "412-491-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 NORTHRIDGE DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152372002",
            "telephone_number": "412-491-8812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653 Bluefield Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179626",
            "country_code": "US",
            "telephone_number": "704-360-6460",
            "fax_number": "980-444-2631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286254302",
            "country_code": "US",
            "telephone_number": "704-380-6900",
            "fax_number": "704-380-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTOCCHI",
        "first_name": "JEREMY",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.