J Patrick Bertroche, D.O.
Individual provider Active NPI Psychiatry Physician · Des Moines, IA
NPI 1861559486 · NPPES record last updated Aug 9, 2016
Key facts
- NPI
- 1861559486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 03220 (IA)
- Practice address
- 5525 Meredith Dr
Suite B
Des Moines, IA 50310-2334 - Phone
- (515) 334-9484
- Fax
- (515) 334-9498
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03220 | IA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Des Moines Anesthesiologists PC | Past | Accepting new patients | |
| T Med Behavioral Inc | Psychiatry | Past | Accepting new patients |
| Bertroche & Associates | Psychiatry | Past | Accepting new patients |
| Poweshiek County Mental Health Center | Past | Accepting new patients | |
| Capstone Behavioral Healthcare, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 03220 | IA | Yes |
Addresses
Primary practice location
5525 Meredith Dr
Suite B
Des Moines, IA 50310-2334
Mailing address
5525 Meredith Dr
Suite B
Des Moines, IA 50310-2334
Phone (515) 334-9484
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861559486 | Medicaid | IA |
Other providers in Des Moines, IA
- Steven G Berry
- Chad Stephen Bertagni
- Rico Louis Bertagnolli
- Bertroche & Associates
- Adam Bertroche
- Sharon Bertroche
- Karin Beschen
- Leyla Alexandra Best Bandenay
- Bethany Christian Services of South Central Iowa
- David Lee Bethel
All providers in Des Moines, IA · Psychiatry Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.