Active NPI
Marielle Elise Bertram, DPT
- Physical Therapist
- Kirkland, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 11620 97TH LN NE
Kirkland, WA 98034-4269 - Phone
- (425) 455-2630
- Fax
- (425) 451-4390
- NPI assigned
- Feb 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 28367 | MD | |
| Physical Therapist | 225100000X | 2305210875 | VA | |
| Physical Therapist | 225100000X | WA | Primary |
Addresses
Primary practice location
11620 97TH LN NE
Kirkland, WA 98034-4269
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other practice location 1
2618 N Salisbury Blvd Ste 130
Salisbury, MD 21801-2217
Phone (410) 324-7409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 86.09 of 100
- Quality
- 89.13
- Improvement activities
- 40
- Cost
- 73.57
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.33 of 100
- Quality
- 88.06
- Improvement activities
- 40
- Cost
- 76.31
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305210875 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Effingham Rehab Services, LLC | Physical Therapist | Current | Accepting new patients |
| Ati Holdings of Arizona, LLC | Physical Therapist | Current | Accepting new patients |
| Effingham Rehab Services, Inc | Current | Accepting new patients | |
| Effingham Rehab Services, LLC | Current | Accepting new patients | |
| Ideal Rehabilitation LLC | Past | Accepting new patients |
Locations
1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058
11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204
5110 S Rural Rd
Ste 104
Tempe, AZ 85282
Phone (480) 629-5549
1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288
123 Village At Glynn Pl
Brunswick, GA 31525
Phone (912) 208-5170
172 Tower Rd
Jesup, GA 31545
Phone (912) 427-4290
123 Canal St
Ste 203
Pooler, GA 31322
Phone (912) 388-1283
790 Remington Blvd
Bolingbrook, IL 60440
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
Organizations & group practices 5
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.
-
- Physical Therapist
- Phoenix, AZ
- NPI 1871570309
-
- Rehabilitation Clinic/Center
- Savannah, GA
- NPI 1770006272
-
- Rehabilitation Clinic/Center
- Brunswick, GA
- NPI 1366016032
-
- Rehabilitation Clinic/Center
- Kingsland, GA
- NPI 1780264994
Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- Tucson, AZ
- NPI 1831353614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1922546902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11620 97TH LN NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980344269",
"telephone_number": "425-455-2630",
"fax_number": "425-451-4390"
}
],
"practiceLocations": [
{
"address_1": "2618 N Salisbury Blvd Ste 130",
"address_purpose": "LOCATION",
"city": "Salisbury",
"state": "MD",
"postal_code": "218012217",
"country_code": "US",
"telephone_number": "410-324-7409",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERTRAM",
"first_name": "MARIELLE",
"middle_name": "ELISE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-09",
"last_updated": "2024-04-10",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "28367",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305210875",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.