James Mark Bertola

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

MD27813 Issued in OR

Practice address

3325 N Interstate Ave
Dept of Pain Medicine
Portland, OR 97227-1020

Phone

(503) 331-6131

NPI assigned

Jul 21, 2006

Last updated

Dec 31, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  dba Interstate Radiation Oncology

  • Radiation Oncology Clinic/Center
  • Portland, OR
  • NPI 1093043424
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1811917750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 N INTERSTATE AVE",
            "address_2": "DEPT OF PAIN MEDICINE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271020",
            "telephone_number": "503-331-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 N INTERSTATE AVE",
            "address_2": "DEPT OF PAIN MEDICINE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271020",
            "telephone_number": "503-331-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLA",
        "first_name": "JAMES",
        "middle_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A94417",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OR",
            "license": "MD27813",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CO",
            "license": "45911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Louis Bertagnolli, LCSW
• Marcia Bertalot, ANP
• Jennifer S Bertapelle, LCSW
• Bertik Chiropractic Enterprises, LLC (Portland Center for Spinal Correction)
• Josi L Bertling, LMT
• Andrea Marie Bertoni, PHARMD
• Elvira Bertrand
• Juliana Bertucci
• Marissa Jane Bertucci, PC-A
• Stephanie Berzon

• Pain Medicine (Anesthesiology) Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pain Medicine (Anesthesiology) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.