Individual provider Active NPI

Melaine Joy Bertotti, PA-C

  • Medical Physician Assistant
  • Arvada, CO
National Provider Identifier
1649428327
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2651 Issued in CO
Practice address
12001 W 63Rd PL
Arvada, CO 80004-4034
Phone
(303) 423-1360
Fax
(303) 423-1640
NPI assigned
Sep 5, 2008
Last updated
Sep 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2651 CO Primary

Addresses

Primary practice location

12001 W 63Rd PL
Arvada, CO 80004-4034

Mailing address

12001 W 63Rd PL
Arvada, CO 80004-4034
Phone (303) 423-1360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2651COMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1649428327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 W 63RD PL",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044034",
            "telephone_number": "303-423-1360",
            "fax_number": "303-423-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12001 W 63RD PL",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044034",
            "telephone_number": "303-423-1360",
            "fax_number": "303-423-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOTTI",
        "first_name": "MELAINE",
        "middle_name": "JOY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.