Active NPI
Patrick J Bertolini, M.D.
- Family Medicine Physician
- Lincoln, NE
National Provider Identifier
1750330189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 16656
- Practice address
- 3540 Village Dr
Suite 100
Lincoln, NE 68516-4706 - Phone
- (402) 420-7113
- NPI assigned
- May 10, 2006
- Last updated
- May 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 16656 | NE | Primary |
Addresses
Primary practice location
3540 Village Dr
Suite 100
Lincoln, NE 68516-4706
Mailing address
3540 Village Dr
Suite 100
Lincoln, NE 68516-4706
Phone (402) 420-7113
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080094114 | Other | NE | MEDICARE TRAVELERS |
| 06213 | Other | NE | BCBS PROVIDER NUMBER |
| 10025250200 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Nebraska College of Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3540 Village Dr
Suite 100
Lincoln, NE 68516-4706
Phone (402) 483-3885
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bryan Physician Network | Family Medicine | Current | Accepting new patients |
| Cheney Ridge Family Medical Clinic, PC | Family Medicine | Current | Accepting new patients |
Locations
2222 S 16th St
Ste 400A
Lincoln, NE 68502
Phone (402) 475-8877
2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042
3540 Village Dr
Ste 100
Lincoln, NE 68516
Phone (402) 420-7113
Interoperability endpoints
- pbertolini14341@hisp.bryanhealth.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Lincoln, NE
- NPI 1679528798
-
- Family Medicine Physician
- Lincoln, NE
- NPI 1801367909
-
- General Practice Physician
- Lincoln, NE
- NPI 1003044660
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lincoln, NE
- NPI 1528006103
-
dba Bryan Medical Center Laboratory
- Clinical Medical Laboratory
- Lincoln, NE
- NPI 1689203077
Hospital
-
- Home Health Agency
- Bellevue, NE
- NPI 1588792022
-
dba Madonna Rehabilitation Hospital Lincoln
- Rehabilitation Hospital
- Lincoln, NE
- NPI 1558458091
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1750330189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 VILLAGE DR",
"address_2": "SUITE 100",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164706",
"telephone_number": "402-420-7113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 VILLAGE DR",
"address_2": "SUITE 100",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164706",
"telephone_number": "402-420-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTOLINI",
"first_name": "PATRICK",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "16656",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE TRAVELERS",
"identifier": "080094114",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "06213",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025250200",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.