Individual provider Active NPI

Matthew Bertollini, D.C.

  • Chiropractor
  • Sterling Heights, MI
National Provider Identifier
1316944929
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3460 Issued in OH
Practice address
14300 15 Mile Rd
Sterling Heights, MI 48312-5510
Phone
(586) 979-6460
Fax
(586) 979-4005
NPI assigned
Jun 29, 2005
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3460 OH Primary

Addresses

Primary practice location

14300 15 Mile Rd
Sterling Heights, MI 48312-5510

Mailing address

14300 15 Mile Rd
Sterling Heights, MI 48312-5510
Phone (586) 979-6460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180522002152 MI Practitioner - Chiropractic 0042239303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macomb Rehab MethodsGroup PAC ID 4183988983, 2 clinicians

Practice addresses (Care Compare)

14300 15 Mile Rd
Sterling Heights, MI 48312-5510
Phone (586) 979-6460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3460OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Macomb Chiropractic Centers, P.C. Chiropractor CurrentSince May 1, 2018 Accepting new patients
Macomb Rehab Methods Chiropractor CurrentSince May 1, 2018 Accepting new patients
Glass City Spine Chiropractor PastSince Jun 18, 2023 Accepting new patients
Chiropractic First of Michigan PLLC Chiropractor PastSince Mar 4, 2021 Accepting new patients
Herfert Chiropractic Clinic P C Chiropractor PastSince Aug 26, 2013 Accepting new patients

Locations

14300 15 Mile Rd
Sterling Heights, MI 48312
Phone (586) 855-1044

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.

NPI Registry JSON

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1316944929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483125510",
            "telephone_number": "586-979-6460",
            "fax_number": "586-979-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483125510",
            "telephone_number": "586-979-6460",
            "fax_number": "586-979-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLLINI",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.