Individual provider Active NPI

Michelle L Bertke, APN,CNP

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1710922182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2312
Fax
(309) 655-4154
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000

Other identifiers 1

IdentifierTypeStateIssuer
207414OtherMEDICARE GROUP NO.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731004094 NJ Practitioner - Nurse Practitioner 8325051576 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Am PM Walk in Urgent Care ClinicGroup PAC ID 5092954602, 79 clinicians

Practice addresses (Care Compare)

19 S Washington Ave
Bergenfield, NJ 07621-2324
Phone (201) 387-0177

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-005757ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DRX Paramus, LLC CurrentSince Jul 8, 2024 Accepting new patients
Am PM Walk in Urgent Care Clinic CurrentSince Jun 15, 2024 Accepting new patients
The Radiology Group of New Jersey, LLC CurrentSince Feb 1, 2025 Accepting new patients
Am PM Primary Care PastSince Jun 15, 2024 Accepting new patients
Monmouth Digestive Health LLC PastSince Aug 17, 2020 Accepting new patients

Locations

19 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 387-0177

2001 College Dr
Ste 11
Clementon, NJ 08021
Phone (856) 566-3333

145 Wyckoff Rd
Ste 201
Eatontown, NJ 07724
Phone (732) 597-7333

57 US Highway 46
Ste 212
Hackettstown, NJ 07840

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

2 Broadway
Hillsdale, NJ 07642
Phone (201) 523-9222

175 High St
Newton, NJ 07860
Phone (973) 383-2121

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652
Phone (201) 262-2010

278 Route 10
Succasunna, NJ 07876
Phone (624) 775-2888

Organizations & group practices 5

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

Hospital & facility affiliations 1

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710922182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000",
            "fax_number": "309-655-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2312",
            "fax_number": "309-655-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTKE",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "APN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NO.",
            "identifier": "207414",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.