Individual provider Active NPI

Cristiana M Bertocchi, MD

  • Surgery Physician
  • Lewiston, ME
National Provider Identifier
1851432363
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD602082383 Issued in WA
Practice address
12 High St
Ste. 401
Lewiston, ME 04240-7676
Phone
(207) 795-5767
Fax
(207) 795-5691
NPI assigned
Feb 8, 2007
Last updated
Jun 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD18217 ME
Surgery Physician 208600000X MD423091 PA
Surgery Physician 208600000X MD602082383 WA Primary

Addresses

Primary practice location

12 High St
Ste. 401
Lewiston, ME 04240-7676

Mailing address

12 High St
Ste. 401
Lewiston, ME 04240-7676
Phone (207) 795-5767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111121000108 HI Practitioner - General Surgery 3476648684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Pittsburgh School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Practice addresses (Care Compare)

3-3420 Kuhio Hwy
Suite B
Lihue, HI 96766-1098
Phone (808) 245-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
79.9
Promoting interoperability
99
Improvement activities
40
Cost
82.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD602082383WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Medical Clinic CurrentSince Aug 10, 2015 Accepting new patients
Kauai Medical Clinic CurrentSince Aug 10, 2015 Accepting new patients

Locations

1946 Young St
Ste 320
Honolulu, HI 96826

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

Organizations & group practices 2

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.

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1851432363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "address_2": "STE. 401",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407676",
            "telephone_number": "207-795-5767",
            "fax_number": "207-795-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "address_2": "STE. 401",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407676",
            "telephone_number": "207-795-5767",
            "fax_number": "207-795-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOCCHI",
        "first_name": "CRISTIANA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD18217",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD423091",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD602082383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.