RILEY S BERTRAM (NPI# 1942815063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942815063 |
| Entity Type | Individual |
| Full Name | RILEY S BERTRAM |
| Practice Address |
202 South Park Street 4 Tower Madison WI 53715 |
| Mailing Address |
12105 65th Cir Ne Otsego MN 55301-4679 |
| Practice Telephone | 6084176676 |
| Mailing Telephone | 6122196180 |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
202 SOUTH PARK STREET 4 TOWER |
| City | MADISON |
| State | WI |
| Zip Code | 53715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013915925 | Laurence Ross Rothstein | Anesthesiology | 202 South Park Street, C/o Madison Anesthesiology Consultants, LLP, Madison, WI 53715 | 2005-07-13 |
| 1871972851 | Samuel Kurtis | Anesthesiology | 202 South Park Street, 4 Tower, Madison, WI 53715 | 2015-05-25 |
| 1710915640 | Sarah Rauch Heiser | Emergency Medicine | 202 South Park Street, Meriter Hospital, Madison, WI 53715 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1578927026 | Petra A Kelsey | Family Medicine | 1107 Emerald St, Madison, WI 53715 | 2016-04-11 |
| 1467889238 | Group Health Cooperative of South Central Wi | Durable Medical Equipment & Medical Supplies | 740 Regent Street, Suite 106, Madison, WI 53715 | 2013-10-10 |
| 1275888760 | Sandra Beth Miller | Physician Assistant | 700 S. Park, Suite A 404, Madison, WI 53715 | 2012-07-20 |
| 1134418486 | Matthew Lochen | Emergency Medicine | 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 | 2011-04-06 |
| 1225275720 | Eileen J Breitweiser | Social Worker | 202 South Parkt Street, Madison, WI 53715 | 2009-01-21 |
| 1225293137 | Kenneth H. Yuska, Md, Sc | Orthopaedic Surgery | 4726 East Towne Blvd., 110, Madison, WI 53715 | 2008-07-21 |
| 1063689727 | Rachel I Kornik | Dermatology | Uw Health Dept of Dermatology 1 S. Park St, Administrative Office 7th Floor, Madison, WI 53715 | 2008-05-13 |
| 1144434911 | Rebecca Sue Frye | Pharmacist | 1 South Park Street, Suite 101 Pharmacy, Madison, WI 53715 | 2007-05-10 |
| 1376755496 | Eileen C. Scrivner | Social Worker | 1008 Fish Hatchery Road, Madison, WI 53715 | 2007-05-03 |
| Find all providers in zip 53715 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054668 | Brandon Camel | Anesthesiologist Assistant | 619 N Segoe Rd, Madison, WI 53705-3112 | 2019-07-12 |
| 1669857660 | Cayla Joanne Dittmer | Anesthesiologist Assistant | 818 N Star Dr Apt 119, Madison, WI 53718-3011 | 2015-07-21 |
| 1891761383 | William L Campbell | Anesthesiologist Assistant | 4830 Woodburn Dr, Madison, WI 53711-1346 | 2006-02-24 |
| 1790392736 | Rachel Mcallister | Anesthesiologist Assistant | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-24 |
| 1801412606 | Trevor Francis Boensch | Anesthesiologist Assistant | 202 S Park St, Madison, WI 53715-1507 | 2020-06-18 |
| 1245856954 | Kevin A. Mayes | Anesthesiologist Assistant | 600 Highland Ave, Madison, WI 53792-0001 | 2020-06-18 |
| 1346865581 | Bethany A. Meyering | Anesthesiologist Assistant | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2020-06-13 |
| 1750905931 | Allison Schroeder | Anesthesiologist Assistant | 600 Highland Ave, Madison, WI 53792-0001 | 2020-06-03 |
| 1558992453 | Addie M Berens | Anesthesiologist Assistant | 600 Highland Ave, Madison, WI 53792-0001 | 2020-01-29 |
| 1316578628 | Joel Zembles | Anesthesiologist Assistant | 600 Highland Ave, Madison, WI 53792-0001 | 2020-01-27 |
| Find all providers in MADISON | ||||
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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.