Antonia Efua Bertram, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9497 Issued in WI

Practice address

1211 Fish Hatchery Rd
Madison, WI 53715-1909

Phone

(608) 252-8000

Fax

(608) 283-7160

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Antonia Efua Eshun Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083

Medicare enrollment (NPD)

Enrolled

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.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care of Wisconsin, Inc.

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1386299154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 Fish Hatchery Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151911",
            "country_code": "US",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "ANTONIA",
        "middle_name": "EFUA",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9497-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386299154",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aeshun271320@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "aeshun271320@direct-ehr-ssmhc.com",
            "address_1": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANTONIA",
            "last_name": "ESHUN",
            "middle_name": "EFUA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joanne Berschet, CADC III, BA
• Kimberly Bertagnoli, RN
• Lucy A. Bertelsen, OT
• Alexandra Marie Berthelon-Lathrop
• Marlene Helen Berthiaume
• Douglas Edward Bertram, L.AC
• Henry Bertram, PHARMD
• Jennifer Ann Bertram, L.AC
• Samuel Taylor Bertram, RN
• Eve Bertrand, APSW

• Nurse Practitioner in Madison, WI
• Providers in Madison, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.
• 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.