NPIMap

Individual provider Active NPI

Steven Luke Berthelsen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Vista, CA
National Provider Identifier
1710222443
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1938 Issued in CA
Practice address
2067 W Vista Way
#265
Vista, CA 92083-6031
Phone
(760) 463-9155
NPI assigned
Dec 6, 2012
Last updated
Aug 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E5190 CA
Foot & Ankle Surgery Podiatrist 213ES0103X 1938 CA Primary

Addresses

Primary practice location

2067 W Vista Way
#265
Vista, CA 92083-6031

Mailing address

2067 W Vista Way
#265
Vista, CA 92083-6031
Phone (760) 463-9155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150603000289 CA Practitioner - Podiatry 2264753284 Reassigns benefits to 1 organization
O20180824001578 CA DME Supplier - Physician - Podiatry 0941564371 Practice locations: Vista, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S Luke Berthelsen DPM IncGroup PAC ID 0941564371, 2 clinicians

Practice addresses (Care Compare)

2067 W Vista Way
Suite 265
Vista, CA 92083-6034
Phone (760) 463-9155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.51 of 100Reported as group
Quality
77.61
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue131
Removal of skin lesions1-10
Removal of nail tissue280
Removal or shaving of skin growth119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5190CAMDFoot & Ankle Surgery Podiatrist
1938CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
S. Luke Berthelsen DPM, Inc Foot & Ankle Surgery CurrentSince Jan 19, 2018 Accepting new patients
Scripps Health Past Accepting new patients
Tri-City Hospital Past Accepting new patients

Locations

2067 W Vista Way
Ste 265
Vista, CA 92083
Phone (760) 295-2995

Interoperability endpoints

  • Direct secure messaging: foundation.slukeberthelsen@146737.advancedmd-direct.com
  • Direct secure messaging: sberthelsen43339@scrippshlth.medalliesdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1710222443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "#265",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-463-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "#265",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-463-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTHELSEN",
        "first_name": "STEVEN",
        "middle_name": "LUKE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-06",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5190",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "1938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.