Individual provider Active NPI

David A Vertullo, MD

  • Specialist
  • Scottsdale, AZ
National Provider Identifier
1366412462
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
34938 Issued in AZ
Practice address
8144 E Cactus Rd
Suite 800
Scottsdale, AZ 85260-5266
Phone
(480) 596-8525
Fax
(480) 596-8522
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101050557 VA
Specialist 174400000X 34938 AZ Primary

Addresses

Primary practice location

8144 E Cactus Rd
Suite 800
Scottsdale, AZ 85260-5266

Mailing address

8144 E Cactus Rd
Suite 800
Scottsdale, AZ 85260-5266
Phone (480) 596-8525

Other identifiers 2

IdentifierTypeStateIssuer
0440730OtherAZBLUE CROSS BLUE SHIELD
109820MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101050557VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portsmouth Anesthesia Associates, P.C. Anesthesiology Past Accepting new patients

Organizations & group practices 1

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1366412462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8144 E CACTUS RD",
            "address_2": "SUITE 800",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605266",
            "telephone_number": "480-596-8525",
            "fax_number": "480-596-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8144 E CACTUS RD",
            "address_2": "SUITE 800",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605266",
            "telephone_number": "480-596-8525",
            "fax_number": "480-596-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERTULLO",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101050557",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "34938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0440730",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109820",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.