Individual provider Active NPI

Danielle Rose Bertke

  • Physical Therapist
  • Anna, OH
National Provider Identifier
1487484549
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021290 Issued in OH
Practice address
515 E Main St Ste D
Anna, OH 45302-9440
Phone
(937) 639-2063
NPI assigned
Aug 5, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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 PT021290 OH Primary

Addresses

Primary practice location

515 E Main St Ste D
Anna, OH 45302-9440

Mailing address

515 E Main St Ste D
Anna, OH 45302-9440
Phone (937) 639-2063

Other practice location 1

830 Falls Creek Dr
Vandalia, OH 45377-8600
Phone (937) 890-9235

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120001536 OH Practitioner - Physical Therapist in Private Practice 6305371972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Xcel Physical Therapy LLCGroup PAC ID 9032525696, 16 clinicians

Practice addresses (Care Compare)

515 E Main St
Suite D
Anna, OH 45302-9440
Phone (937) 639-2063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT021290OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Xcel Physical Therapy LLC Physical Therapist CurrentSince Jul 29, 2024 Accepting new patients
Xcel Sports Medicine CurrentSince Jul 29, 2024 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

515 E Main St
Ste D
Anna, OH 45302
Phone (937) 639-2063

3916 Indian Ripple Rd
Dayton, OH 45440

3916 Indian Ripple Rd
Ste 150
Dayton, OH 45440
Phone (937) 702-9735

830 Falls Creek Dr
Vandalia, OH 45377
Phone (937) 890-9235

Organizations & group practices 2

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": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1487484549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E MAIN ST STE D",
            "city": "ANNA",
            "state": "OH",
            "postal_code": "453029440",
            "telephone_number": "937-639-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E MAIN ST STE D",
            "city": "ANNA",
            "state": "OH",
            "postal_code": "453029440",
            "telephone_number": "937-639-2063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Falls Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Vandalia",
            "state": "OH",
            "postal_code": "453778600",
            "country_code": "US",
            "telephone_number": "937-890-9235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTKE",
        "first_name": "DANIELLE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.