Mark Paul Bortolussi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901016722 Issued in MI

Practice address

213 East Michigan Ave
Marshall, MI 49068

Phone

(269) 781-1108

Fax

(269) 781-9164

NPI assigned

Aug 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639285752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 EAST MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "49068",
            "telephone_number": "269-781-1108",
            "fax_number": "269-781-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 EAST MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "49068",
            "telephone_number": "269-781-1108",
            "fax_number": "269-781-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTOLUSSI",
        "first_name": "MARK",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kaitlyn Nicole Britten, PA-C, ATC
• Bronson Battle Creek Hospital

• Dentist in Marshall, MI
• Providers in Marshall, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.