Individual provider Active NPI

Natalie Marie Keller-Bertolino, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1376778480
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015668 Issued in PA
Practice address
9712 Bustleton Ave Apt 34
Philadelphia, PA 19115-3148
Phone
(484) 716-4525
Fax
(215) 646-3695
NPI assigned
May 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW015668 PA Primary

Addresses

Primary practice location

9712 Bustleton Ave Apt 34
Philadelphia, PA 19115-3148

Mailing address

9712 Bustleton Ave Apt 34
Philadelphia, PA 19115-3148
Phone (484) 716-4525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190305000208 PA Practitioner - Clinical Social Worker 3173862471 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9712 Bustleton Ave
Apt 34
Philadelphia, PA 19115-3148
Phone (215) 646-3695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW015668PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Schwarz and Associates Inc Clinical 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": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1376778480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9712 BUSTLETON AVE APT 34",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153148",
            "telephone_number": "484-716-4525",
            "fax_number": "215-646-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9712 BUSTLETON AVE APT 34",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153148",
            "telephone_number": "484-716-4525",
            "fax_number": "215-646-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER-BERTOLINO",
        "first_name": "NATALIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-18",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.