Giancarlo Bertozzi, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

ME0020514 Issued in FL

Practice address

3599 University Blvd S
Suite 802
Jacksonville, FL 32216-4252

Phone

(904) 396-2421

Fax

(904) 398-1854

NPI assigned

Jul 1, 2005

Reactivated

Mar 29, 2006

Last updated

Feb 22, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Giancarlo Bertozzi MD PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Jacksonville, FL
  • NPI 1699081356
  Authorized official Same address or phone

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1578560835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "SUITE 802",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-396-2421",
            "fax_number": "904-398-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "SUITE 802",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-396-2421",
            "fax_number": "904-398-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOZZI",
        "first_name": "GIANCARLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2008-02-22",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME0020514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00013539",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHEASE",
            "identifier": "310091",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "16933",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4081875",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL HEALTHCARE",
            "identifier": "3690",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4009642-002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "207738",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "310091",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marsha F Bertholf, M.D.
• Ronville S Bertie, LMHC
• Suzanne Michele Bertisch, M.D., M.P.H.
• Leah Bertoch
• Sara Cummings Bertoch, PHD
• Caroline Suzanne Bertsch, MS, CGC
• Breana T Bess, MD
• Kevin Andrew Bess, CAA
• Rebecca Bessent-Hall, LPN
• Kimberly Besser, CRNA

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.