Individual provider Active NPI

Eva Bertrand

  • Physical Therapist
  • Arlington, TX
National Provider Identifier
1548580608
Registry record updated Jul 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1094589 Issued in TX
Practice address
801 Road to Six Flags W Ste 105
Arlington, TX 76012-2615
Phone
(817) 462-8111
Fax
(817) 462-8110
NPI assigned
Jun 10, 2010
Last updated
Jul 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2023

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 1094589 TX Primary

Addresses

Primary practice location

801 Road to Six Flags W Ste 105
Arlington, TX 76012-2615

Mailing address

801 Road to Six Flags W Ste 105
Arlington, TX 76012-2615
Phone (817) 462-8111

Other identifiers 2

IdentifierTypeStateIssuer
283647002MedicaidTX
TXB113718OtherTXMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110502000037 TX Practitioner - Physical Therapist in Private Practice 4981889243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physical Therapy, PLLCGroup PAC ID 5991980252, 2 clinicians

Practice addresses (Care Compare)

801 Rd to Six Flags W
Suite 105
Arlington, TX 76012-2615
Phone (817) 462-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy, PLLC Physical Therapist CurrentSince Sep 9, 2010 Accepting new patients

Locations

801 Road To Six Flags W
Ste 105
Arlington, TX 76012
Phone (817) 274-6532

801 Road To Six Flags W
Ste 147
Arlington, TX 76012
Phone (817) 462-8111

Interoperability endpoints

  • Direct secure messaging: eva.bertrand.1@19934.direct.athenahealth.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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1548580608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROAD TO SIX FLAGS W STE 105",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122615",
            "telephone_number": "817-462-8111",
            "fax_number": "817-462-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 ROAD TO SIX FLAGS W STE 105",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122615",
            "telephone_number": "817-462-8111",
            "fax_number": "817-462-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAND",
        "first_name": "EVA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1094589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283647002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "TXB113718",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2023; 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.