Mary Ann Bertuso, PAC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

1063023 Issued in WI

Practice address

1969 W Hart Road
Beloit, WI 53511

Phone

(608) 758-7215

Fax

(608) 758-3216

NPI assigned

Aug 13, 2007

Last updated

Nov 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: mbertuso258685@direct-ehr-ssmhc.com

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1689866840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 N RANDALL AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451122",
            "telephone_number": "608-758-7215",
            "fax_number": "608-758-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART ROAD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "53511",
            "telephone_number": "608-758-7215",
            "fax_number": "608-758-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTUSO",
        "first_name": "MARY ANN",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "1063023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbertuso258685@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mbertuso258685@direct-ehr-ssmhc.com",
            "address_1": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api.FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jamie G Bengtson, SW
• Emily Kendra Berquist, APNP
• Angela M Besaw, NP
• Shana Best, LMT
• Jenniffer Beu, LPC
• Indira Bhagwandin, APNP
• Bradley James Billeter, CNP

• Emergency Medicine Physician in Beloit, WI
• Providers in Beloit, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.