Adam J Bertuli, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Green Bay, WI
NPI 1306384995 · NPPES record last updated Oct 24, 2022
Key facts
- NPI
- 1306384995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 209022633 (IL)
- Practice address
- 744 S Webster Ave
Green Bay, WI 54301-3505 - Phone
- (920) 445-7226
- Fax
- (920) 445-7229
- NPI assigned
- Feb 3, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North American Partners in Anesthesia Illinois LLC
Practice addresses (Care Compare)
2020 W Iles Ave
Springfield, IL 62704-4174
Phone (217) 814-8054
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100
Hospital & facility affiliations
- St Johns Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221104001316 | IL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9739462078 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209022633 | IL | MD | Certified Registered Nurse Anesthetist |
| 232150-30 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia (Illinois), LLC | Current |
Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 232150-30 | WI | |
| Certified Registered Nurse Anesthetist | 367500000X | 209022633 | IL | Yes |
Addresses
Primary practice location
744 S Webster Ave
Green Bay, WI 54301-3505
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other providers in Green Bay, WI
- Carla Renee Berscheit
- Mark W Bertagnoli
- Danielle Bertrand
- Mitchell Bertrand
- Ursula Bertrand
- Crystal D Besaw
- Karen Besiada Hansen
- Besiada Health Innovators, LLC
- Best Optical LLC
- Samantha Bestul
All providers in Green Bay, WI · Certified Registered Nurse Anesthetist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.