Individual provider Active NPI

Amanda Marie Bertram, DNP

  • Family Nurse Practitioner
  • Yuma, AZ
National Provider Identifier
1902654551
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
324556 Issued in AZ
Practice address
11142 S Scottsdale Dr
Yuma, AZ 85367-5616
Phone
(928) 336-1815
Fax
(928) 342-3850
NPI assigned
May 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 67026 ID
Family Nurse Practitioner 363LF0000X C-APN.0102462-C-NP CO
Family Nurse Practitioner 363LF0000X 324556 AZ Primary

Addresses

Primary practice location

11142 S Scottsdale Dr
Yuma, AZ 85367-5616

Mailing address

2400 S Avenue a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Other practice location 1

2121 North Ave
Grand Junction, CO 81501-6428
Phone (970) 242-0731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250722001236 AZ Practitioner - Nurse Practitioner 6901312479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Hospital & facility affiliations

  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-APN.0102462-C-NPCOMDFamily Nurse Practitioner
67026IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Jul 27, 2025 Accepting new patients
Yuma Regional Medical Center CurrentSince Jul 27, 2025 Accepting new patients

Locations

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

11142 S Scottsdale Dr
Yuma, AZ 85367
Phone (928) 336-1815

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 and National Provider Directory roles.

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": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1902654551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "928-344-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11142 S SCOTTSDALE DR",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853675616",
            "telephone_number": "928-336-1815",
            "fax_number": "928-342-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 North Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815016428",
            "country_code": "US",
            "telephone_number": "970-242-0731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "67026",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0102462-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "324556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.