NPIMap

Organization Active NPI

Tobias Moeller-Bertram MD Corporation

  • Pain Medicine (Anesthesiology) Physician
  • San Jacinto, CA
National Provider Identifier
1366339673
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
TOBIAS MOELLER-BERTRAM MD CORPORATION
Practice address
1695 S San Jacinto Ave Ste a, C & D
San Jacinto, CA 92583-5103
Phone
(951) 330-3100
Fax
(951) 350-1050
NPI assigned
Jun 19, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Tobias Moeller-Bertram, MD
Title
Ceo
Phone
(800) 285-3755

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 56

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2132584Lifekind Health1695 S San Jacinto Ave Ste a, San Jacinto, CA 92583RegistrationMar 19, 2028
05D2324222Lifekind Health1695 S San Jacinto Ave, Suite a, San Jacinto, CA 92583Certificate of waiverMay 19, 2027

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20251031004171 CA DME Supplier - Multi-Specialty - Physician 1456586064 Practice locations: San Jacinto, CA

National Provider Directory

National Provider Directory
Tax ID family
Tobias Moeller Bertram MD (14 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

NPPES NPI Registry

Primary practice location

1695 S San Jacinto Ave Ste a, C & D
San Jacinto, CA 92583-5103

Mailing address

44630 Monterey Ave Ste 100
Palm Desert, CA 92260-3326
Phone (800) 285-3755

Other names 1

NPPES NPI Registry
  • Lifekind Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 11, 2025.

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1366339673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44630 MONTEREY AVE STE 100",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603326",
            "telephone_number": "800-285-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 S SAN JACINTO AVE STE A, C & D",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925835103",
            "telephone_number": "951-330-3100",
            "fax_number": "951-350-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOBIAS MOELLER-BERTRAM MD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "MOELLER-BERTRAM",
        "authorized_official_first_name": "TOBIAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-285-3755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifekind Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.