DR. KYLE ANDREW BERTRAM (NPI# 1356842934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356842934 |
| Entity Type | Individual |
| Full Name | DR. KYLE ANDREW BERTRAM |
| Credential | PHARMD |
| Practice Address |
1353 Dorchester Ave Dorchester MA 02122-2932 |
| Mailing Address |
One Boston Medical Center Place Department of Pharmacy Boston MA 02118 |
| Practice Telephone | 8574096024 |
| Mailing Telephone | 8574096024 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PH236898 | MA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | PHARMACIST LICENSE | PH236898 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003319047 | Kyle Bertram | Student in an Organized Health Care Education/Training Program | 4000 Johnson Rd, Steubenville, OH 43952-2364 | 2018-03-15 |
| Street Address |
1353 DORCHESTER AVE |
| City | DORCHESTER |
| State | MA |
| Zip Code | 02122-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750340410 | Holly L Goodale | Specialist | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2006-03-21 |
| 1841891728 | Christopher White | Physical Therapist | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2020-11-05 |
| 1790393767 | Daniel Rabinowicz | Physical Therapist | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2020-07-16 |
| 1902432826 | Dorreen Danesh | Internal Medicine | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2020-03-23 |
| 1174179857 | Yue Yu | Optometrist | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2019-08-17 |
| 1316410376 | Rachel Wasserman | Nurse Practitioner | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2019-01-02 |
| 1114402807 | Dorchester House Multi Service Center | Clinic/Center | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2018-09-27 |
| 1861988503 | Sirena Huang | Optometrist | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2018-07-05 |
| 1336634526 | Stephen Cronk | Dentist | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2018-06-29 |
| 1417467515 | Jeffrey Young | Dentist | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2017-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033720875 | Joey Mark Nguyen | Pharmacist | 747 Gallivan Blvd, Dorchester, MA 02122 | 2020-08-14 |
| 1518575240 | Hamilton Pharmacy LLC | Pharmacy | 246 Bowdoin St, Dorchester, MA 02122 | 2020-07-20 |
| 1336789528 | Katheline Leconte | Social Worker | 230 Bowdoin Street, Dorchester, MA 02122 | 2020-01-15 |
| 1700374725 | Renee Ahern | Registered Nurse | 398 Neponset Ave., Dorchester, MA 02122 | 2018-04-25 |
| 1861902371 | Bridget Mary Walsh | Specialist/Technologist | 519 Ashmont St, Dorchester, MA 02122 | 2017-10-10 |
| 1649798133 | Roosevelt Lewis IIi | Registered Nurse | 1486 Dorchester Ave Ste 206, Boston, MA 02122 | 2017-09-05 |
| 1811427404 | Hanh Nguyen | Counselor | 50 Redfield St, Suite 300, Dorchester, MA 02122 | 2017-06-15 |
| 1669902474 | Thuy T Nguyen | Counselor | 415 Neponset Avenue, Dorchester, MA 02122 | 2017-06-14 |
| 1093262651 | David Scot Rapaport | Counselor | 1452 Dorchester Avenue, Fcbl-4, Boston, MA 02122 | 2016-09-01 |
| 1104372960 | Kevin Lyn Sisson | Student in an Organized Health Care Education/Training Program | 417 Neponset Ave, Boston, MA 02122 | 2016-08-31 |
| Find all providers in zip 02122 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902419948 | Andrew Stein | Pharmacist | 401 Great Plain Ave, Needham, MA 02492-3735 | 2020-08-28 |
| 1356954010 | Hossein Monzavi | Pharmacist | 25 Carleton St Bldg E-23, Cambridge, MA 02142-1323 | 2020-08-24 |
| 1275151946 | Sima Sheth Patel | Pharmacist | 112 Pine Hill Rd, Bedford, MA 01730-1658 | 2020-07-09 |
| 1750901419 | Tiffany Nicole Powers | Pharmacist | 96 Chestnut St, Foxborough, MA 02035-1444 | 2020-04-23 |
| 1538792270 | Collin O'neill | Pharmacist | 135 Pleasant St Apt 405, Brookline, MA 02446-7187 | 2020-02-21 |
| 1043854391 | Hiral Patel | Pharmacist | 150 Northnoro Road, Suite 4, Southborough, MA 01772 | 2019-10-30 |
| 1376193581 | Andrew Swanner | Pharmacist | 250 W 5th St Apt 3, Boston, MA 02127-4604 | 2019-09-19 |
| 1235799016 | Vi Dang | Pharmacist | 1175 Chestnut St Unit 24, Newton Upper Falls, MA 02464 | 2019-06-14 |
| 1558843896 | Laura Elizabeth Martin | Pharmacist | 133 Old Rd 9 Acre Cor, Concord, MA 01742-4169 | 2018-09-04 |
| 1487183380 | Benjamin Laliberte | Pharmacist | 55 Fruit St # St-005, Boston, MA 02114-2621 | 2017-06-06 |
| Find all providers with the same taxonomy | ||||
| City | DORCHESTER |
| Zip Code | 02122 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.