John Bertucci, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9312 Issued in MN

Practice address

1155 County Road E E
Vadnais Heights, MN 55110-5183

Phone

(651) 770-0176

NPI assigned

Sep 23, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Mayo Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Active Life Physical Therapy and Wellness LLCGroup PAC ID 1153760657, 2 clinicians

Physiyo, LLCGroup PAC ID 2668712688, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Active Life Physical Therapy and Wellness LLC

  • Orthopedic Physical Therapist
  • Edina, MN
  • NPI 1205694742
  Medicare reassignment Care Compare group NPD Authorized official
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Physiyo, LLC

  • Physical Therapy Clinic/Center
  • Savage, MN
  • NPI 1891250635

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1588090534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 MINNETONKA BLVD",
            "address_2": "APT 108",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554165711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 COUNTY ROAD E E",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105183",
            "telephone_number": "651-770-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTUCCI",
        "first_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Bentz, CNS
• Emily Dawn Berglund, MA, CCC-SLP
• Yafet W Berhane
• Abby Katrina Bernstein, PA-C
• Michaela Bertsch, PA-C
• Lori Marie Bethke, MD
• Collin Jon Beyer, DO
• Reide T Bibeau-Peper
• Jonathan Biebl, MD
• Patricia Lynn Bina

• Physical Therapist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.