MS. JESSICA ANN BERTALAN PA-C NPI 1669668927

NPI Information

NPI: 1669668927
Provider Name: MS. JESSICA ANN BERTALAN, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: MARY FREE BED REHABILITATION HOSPITAL

PECOS Registration: Yes

Address:
235 WEALTHY ST SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 840-8005
Get Directions

MS. Jessica Ann Bertalan, PA-C is a medical physician assistant in Grand Rapids, MI with 17 years of experience. MS. Jessica Ann Bertalan, PA-C NPI is 1669668927. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

235 WEALTHY ST SE
GRAND RAPIDS, MI
ZIP 49503-247
Phone: (616) 840-8005
Fax: (616) 840-9642

The NPI 1669668927 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 9/20/2007 and was last updated on 3/31/2021.

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
1	363AM0700X	Physician Assistant	Medical	5601005126	MICHIGAN	Yes

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
1	MI1763010	OTHER	MICHIGAN	MEDICARE

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: 11/14/2023

NPI Synchronization or Removal

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