DR. JERRY RUSSELL BARTLESON M.D. NPI 1386686376

NPI Information

  • NPI: 1386686376
  • Provider Name: DR. JERRY RUSSELL BARTLESON, M.D.
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7434 SONG LAKE RD
    TULLY, NY
    ZIP 13159
  • Phone: (315) 696-5539

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NPI Details

DR. Jerry Russell Bartleson, M.D. is an emergency medicine in Tully, NY with 42 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Jerry Russell Bartleson, M.D. NPI is 1386686376. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7434 SONG LAKE RD
TULLY, NY
ZIP 13159-211
Phone: (315) 696-5539
Fax: (315) 696-5539

The NPI 1386686376 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency Medicine31435MINNESOTANo
2207P00000XEmergency Medicine28860WISCONSINNo
3207P00000XEmergency Medicine163749NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1163749MEDICAIDNEW YORK
2E16112MEDICARE UPINNEW YORK
3CC3538MEDICARE ID-TYPE UNSPECIFIEDNEW YORK
431522700MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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