Charles Joseph Bertuch Jr., M.D.

Primary specialty

Independent Medical Examiner PhysicianTaxonomy code 202C00000X

License

099426 Issued in NY

Practice address

1120 E Elizabeth Street
Fort Collins, CO 80524

Phone

(970) 493-9193

Fax

(970) 639-4475

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Skilled Facility Health Care Solutions Inc

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1104018423

  CO, Single Specialty

  Medicare reassignment NPD
• Amsterdam Orthopedics, Charles J Bertuch,Jr,MD,PC

  • Specialist
  • Amsterdam, NY
  • NPI 1003051905
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1316056013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E ELIZABETH STREET",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80524",
            "telephone_number": "970-493-9193",
            "fax_number": "970-639-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E ELIZABETH STREET",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80524",
            "telephone_number": "970-493-9193",
            "fax_number": "970-639-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTUCH",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "99421-1",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CO",
            "license": "DR.0052261",
            "primary": false
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Independent Medical Examiner",
            "state": "NY",
            "license": "099426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00553493",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHPLAN",
            "identifier": "18111",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0000CM0523",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSH NE NY",
            "identifier": "000405418002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Bernier, BCBA
• Judy E Berry, MS
• Sydney Berry, RN
• Suzanne Lynn Bertram, MD
• Candace Suzanne Bertsch, CLC
• Olivia Anne Bescak
• Kelby F Bethards, MD
• Bethesda Foundation
• Gina Betley, PT
• Donna Betschowa, CAC 111

• Independent Medical Examiner Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Independent Medical Examiner Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.