Individual provider Active NPI

Maude Bertovich, MSPT

  • Physical Therapist
  • Sterling, VA
National Provider Identifier
1407008410
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305831276 Issued in VA
Practice address
21475 Ridgetop Cir
Suite 260
Sterling, VA 20166-6580
Phone
(703) 433-2500
Fax
(703) 433-2558
NPI assigned
Oct 21, 2008
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305831276 VA Primary

Addresses

Primary practice location

21475 Ridgetop Cir
Suite 260
Sterling, VA 20166-6580

Mailing address

21475 Ridgetop Cir
Suite 260
Sterling, VA 20166-6580
Phone (703) 433-2500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130408000251 VA Practitioner - Physical Therapist in Private Practice 6103061577 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis & Sports Orthopaedics PC Physical Therapist CurrentSince Feb 2, 2013 Accepting new patients

Locations

25055 Riding Plz
Ste 260
Chantilly, VA 20152
Phone (703) 272-5000

21475 Ridgetop Cir
Ste 150
Sterling, VA 20166
Phone (703) 433-2500

21475 Ridgetop Cir
Ste 260
Sterling, VA 20166
Phone (703) 433-0401

Interoperability endpoints

  • Direct secure messaging: maude.bertovichdpt.p1@direct.tsiva.nextgenshare.com

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, 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": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1407008410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21475 RIDGETOP CIR",
            "address_2": "SUITE 260",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201666580",
            "telephone_number": "703-433-2500",
            "fax_number": "703-433-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21475 RIDGETOP CIR",
            "address_2": "SUITE 260",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201666580",
            "telephone_number": "703-433-2500",
            "fax_number": "703-433-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOVICH",
        "first_name": "MAUDE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305831276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.