Elisabeth Renee Bertoline, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA20093 Issued in CA

Practice address

2220 E Gonzales Rd Ste 120a-B
Oxnard, CA 93036-3707

Phone

(805) 981-5151

Fax

(805) 981-5150

NPI assigned

Nov 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Elisabeth Renee Fischetti Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elisabeth.bertoline@ventura.cernerdirect.com

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.

• County of Ventura

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Medicare reassignment NPD
• County of Ventura

  • Federally Qualified Health Center (FQHC)
  • Thousand Oaks, CA
  • NPI 1316188253
  NPD
• County of Ventura

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD
• Mahyar Okhovat, M.D. Inc

  • Neurology Physician
  • Agoural Hills, CA
  • NPI 1922484054
  NPD (past)

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1760636252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S VICTORIA AVE, L4615",
            "address_2": "VCHCA - PHYSICIAN SERVICES",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930090003",
            "telephone_number": "805-677-5181",
            "fax_number": "805-677-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 E GONZALES RD STE 120A-B",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930363707",
            "telephone_number": "805-981-5151",
            "fax_number": "805-981-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLINE",
        "first_name": "ELISABETH",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2766",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90873050",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elisabeth.bertoline@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "2220 E Gonzales Rd Ste 120A-B",
            "city": "Oxnard",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930363707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELISABETH",
            "last_name": "FISCHETTI",
            "middle_name": "RENEE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danilo Cinco Bernal, NP
• Bernard E. Kim, D.M.D., Inc.
• Bernard Rubin, O.D., Inc.
• Rafael Bernardino
• Monica Valeria Berry, LICENSED VOCATIONAL
• Sarvenaz Besharat
• Shane Michael Bess
• Breana Monique Betancourt
• Beyond Care Home Health Services, LLC
• Serena Bezdjian, PH.D.

• Physician Assistant in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.