Individual provider Active NPI

Kraig Edward Bertram II, D.O.

  • Pediatrics Physician
  • Salina, KS
National Provider Identifier
1992026439
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
05-36706 Issued in KS
Practice address
501 S Santa Fe Ave
Suite 100
Salina, KS 67401-4189
Phone
(785) 825-2273
Fax
(785) 825-2275
NPI assigned
Jun 18, 2010
Sex
Male
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.42 of 100Reported as group
Quality
79.94
Promoting interoperability
100
Improvement activities
40
Cost
71.45

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20160818001183 KS Practitioner - Pediatric Medicine 9133414972 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-36706KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salina Regional Health Center, Inc. Pediatrics CurrentSince Sep 1, 2016 Accepting new patients
Salina Regional Health Center Inc CurrentSince Sep 1, 2016 Accepting new patients
Salina Regional Health Center, Inc Current Accepting new patients
Salina Regional Health Center, Inc Past Accepting new patients
Comcare, P.a Past Accepting new patients

Locations

400 S Santa Fe Ave
Salina, KS 67401
Phone (785) 452-6019

501 S Santa Fe Ave
Ste 100
Salina, KS 67401
Phone (785) 827-9631

2265 S 9th St
Salina, KS 67401
Phone (785) 452-6000

2090 S Ohio St
Salina, KS 67401
Phone (785) 309-2323

Interoperability endpoints

  • Direct secure messaging: kraig.bertram@srhcdirect.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 05-36706 KS Primary

Addresses

NPPES NPI Registry

Primary practice location

501 S Santa Fe Ave
Suite 100
Salina, KS 67401-4189

Mailing address

501 S Santa Fe Ave
Suite 100
Salina, KS 67401-4189
Phone (785) 825-2273

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
201077750BMedicaidKS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 16, 2020.

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1992026439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S SANTA FE AVE",
            "address_2": "SUITE 100",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674014189",
            "telephone_number": "785-825-2273",
            "fax_number": "785-825-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S SANTA FE AVE",
            "address_2": "SUITE 100",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674014189",
            "telephone_number": "785-825-2273",
            "fax_number": "785-825-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "KRAIG",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "05-36706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201077750B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

Verify at the official NPI Registry.