Bertram Harry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

032955-01 Issued in NY

Practice address

111 E 210TH St
Bronx, NY 10467-2401

Phone

(718) 920-4826

NPI assigned

Jul 31, 2024

Sex

Male

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

Enrolled in NY

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

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: bharry@montefioredirect.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.

• Jamaica Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jamaica, NY
  • NPI 1477505220
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD (past)
• Jamaica Hospital

  • Skilled Nursing Facility
  • Jamaica, NY
  • NPI 1750516795
  NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • Family Medicine Physician
  • New York, NY
  • NPI 1760288278
  NPD

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1902635626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13925 231ST ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132926",
            "telephone_number": "347-277-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "NY",
            "postal_code": "114182832",
            "country_code": "US",
            "telephone_number": "718-206-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13925 231st St",
            "address_purpose": "LOCATION",
            "city": "Laurelton",
            "state": "NY",
            "postal_code": "114132926",
            "country_code": "US",
            "telephone_number": "347-277-3976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRY",
        "first_name": "BERTRAM",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "032955-01",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032955-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Barre Harrison, DDS
• Steven James Harrison
• William Harrison
• Amanda Rivka Harroch, MD
• Harry Jackson MD PC
• Valina Harry
• Harrys Nurses Registry Inc
• James Hart
• Sheryl Annette Hart
• Alex Hartline

• Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.