Organization Active NPI

Ann Marie Bertles MD Professional Association

  • Obstetrics & Gynecology Physician
  • Katy, TX
National Provider Identifier
1629343702
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ANN MARIE BERTLES MD PROFESSIONAL ASSOCIATION
Practice address
23232 Kingsland Blvd Ste E
Katy, TX 77494-2985
Phone
(832) 437-9690
Fax
(832) 437-9694
NPI assigned
Mar 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Authorized official

Name
Ann Marie Bertles, MDNPI 1922263037
Title
President
Phone
(832) 437-9690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

23232 Kingsland Blvd Ste E
Katy, TX 77494-2985

Mailing address

23232 Kingsland Blvd Ste E
Katy, TX 77494-2985
Phone (832) 437-9690

Other identifiers 1

IdentifierTypeStateIssuer
BCBS OF TXOtherTX0032XQ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120519000089 TX Part B Supplier - Clinic/Group Practice 9931362498 Receives reassigned benefits from 2 practitioners
Practice locations: Houston, TX; Katy, TX

National Provider Directory

National Provider Directory

Locations

23232 Kingsland Blvd
Ste E
Katy, TX 77494
Phone (832) 437-9690

628 S Peek Rd
Katy, TX 77450
Phone (832) 437-9690

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1629343702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23232 KINGSLAND BLVD STE E",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942985",
            "telephone_number": "832-437-9690",
            "fax_number": "832-437-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23232 KINGSLAND BLVD STE E",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942985",
            "telephone_number": "832-437-9690",
            "fax_number": "832-437-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN MARIE BERTLES MD PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "BERTLES",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-437-9690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0032XQ",
            "identifier": "BCBS OF TX",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.