Kenneth R. Bertka, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD460346 Issued in PA

Practice address

2830 Easton Ave
Bethlehem, PA 18017-4204

Phone

(484) 526-3555

Fax

(484) 526-3560

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI, PA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.bertka@slpg.direct-sluhn.org

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.

• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment NPD
• Star Community Health, Inc

  • General Practice Physician
  • Bethlehem, PA
  • NPI 1033686159
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Family Medicine

  Medicare reassignment NPD
• St Luke'S Physician Group Inc

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke'S Physician Group, Inc.

  • Internal Medicine Physician
  • Bethlehem, PA
  • NPI 1477603603
  NPD
• Star Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Bethlehem, PA
  • NPI 1942832720
  NPD

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1609865823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180174204",
            "telephone_number": "484-526-3555",
            "fax_number": "484-526-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180174204",
            "telephone_number": "484-526-3555",
            "fax_number": "484-526-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTKA",
        "first_name": "KENNETH",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35050904",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "65395",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD460346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0631472",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609865823",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynne Bernreuther, DMD
• Laura Bernstein, RN
• Brian Matthew Berry, DO
• Jan E. Berry, MSW
• Kalonni Nicole Berry, LPN
• Bet-El Counseling Services, Inc
• Bet-El Counseling Services, Inc
• Marian Michelle Betances
• Taylor Marie Betheil, PA-C
• Bethlehem Anesthesia Management LLC

• Family Medicine Physician in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.