Individual provider Active NPI

Michael Bertolio

  • Student in an Organized Health Care Education/Training Program
  • Scottsdale, AZ
National Provider Identifier
1679348775
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2700 N Hayden Rd Apt 1080
Scottsdale, AZ 85257-1750
Phone
(435) 512-0612
NPI assigned
Nov 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2700 N Hayden Rd Apt 1080
Scottsdale, AZ 85257-1750

Mailing address

2700 N Hayden Rd Apt 1080
Scottsdale, AZ 85257-1750
Phone (435) 512-0612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250609000088 TN Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Pediatric Medicine 1456861517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1679348775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N HAYDEN RD APT 1080",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852571750",
            "telephone_number": "435-512-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N HAYDEN RD APT 1080",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852571750",
            "telephone_number": "435-512-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLIO",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.