Individual provider Active NPI

Patrick Bertz, FNP

  • Family Nurse Practitioner
  • Fitchburg, WI
National Provider Identifier
1508824673
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3964-33 Issued in WI
Practice address
5395 E Cheryl Pkwy
Fitchburg, WI 53711-5395
Phone
(608) 276-4660
Fax
(608) 276-4660
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3964-33 WI Primary

Addresses

Primary practice location

5395 E Cheryl Pkwy
Fitchburg, WI 53711-5395

Mailing address

5395 E Cheryl Pkwy
Fitchburg, WI 53711-5395
Phone (608) 276-4660

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221229000119 NC Practitioner - Nurse Practitioner 0244477834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3964-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
USA Sleep Diagnostic Mobile Service CurrentSince Sep 1, 2022 Accepting new patients
USA Sleep Diagnostic Mobile Service CurrentSince Sep 1, 2022 Accepting new patients

Locations

6030 Daybreak Cir
Ste A150260
Clarksville, MD 21029

2929 Damascus Rd
Fayetteville, NC 28303
Phone (410) 804-5424

Interoperability endpoints

  • Direct secure messaging: pbertz600229@directhisp.wakemed.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1508824673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5395 E CHERYL PKWY",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115395",
            "telephone_number": "608-276-4660",
            "fax_number": "608-276-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5395 E CHERYL PKWY",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115395",
            "telephone_number": "608-276-4660",
            "fax_number": "608-276-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTZ",
        "first_name": "PATRICK",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "3964-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.