Individual provider Active NPI

Madeline Dorothy Bertsch

  • Physician Assistant
  • Spring Hill, FL
National Provider Identifier
1295324937
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117562 Issued in FL
Practice address
3378 Mariner Blvd
Spring Hill, FL 34609-2460
Phone
(352) 796-7171
Fax
(352) 556-4889
NPI assigned
Jan 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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 PA9117562 FL Primary

Addresses

Primary practice location

3378 Mariner Blvd
Spring Hill, FL 34609-2460

Mailing address

3378 Mariner Blvd
Spring Hill, FL 34609-2460
Phone (352) 796-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241218000564 FL Practitioner - Physician Assistant 6002343811 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Healthcare LLC CurrentSince Nov 19, 2023 Accepting new patients

Locations

3378 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 796-7171

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJHGCA/Endpoint/HJHGCA

Organizations & group practices 2

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": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1295324937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3378 MARINER BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346092460",
            "telephone_number": "352-796-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3378 MARINER BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346092460",
            "telephone_number": "352-796-7171",
            "fax_number": "352-556-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCH",
        "first_name": "MADELINE",
        "middle_name": "DOROTHY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "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": "FL",
            "license": "PA9117562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

Verify at the official NPI Registry.