Melissa Bertiaux, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP013330 Issued in PA

Practice address

125 S 9TH St
Ste. 501
Philadelphia, PA 19107-5125

Phone

(215) 543-7002

NPI assigned

Nov 10, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Koka Cardiology PC

  • Internal Medicine Physician
  • Phila, PA
  • NPI 1942610274
  NPD (past)

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

{
    "created_epoch": "1384041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384041600000",
    "number": "1780013755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST",
            "address_2": "STE. 501",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST",
            "address_2": "STE. 501",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075125",
            "telephone_number": "215-543-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTIAUX",
        "first_name": "MELISSA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-10",
        "last_updated": "2013-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP013330",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP013330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Bertalan, VMD
• Irmgard K a Bertelsen, MD
• Djelika Berthe
• Emily Berthiaume, MD
• Christine Ashley Berthoumieux, RD
• Dalesqui Bertier, LPN
• Steve Bertil
• Sarah Bertin, RD
• Nicholas Michael Bertinato, PHARM D
• Jordan E Bertok

• Acute Care Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2013; 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.