DR. NISHA SHASTRI BERTUCCI M.D.
NPI 1215170766
Obstetrics & Gynecology in Grand Rapids, MI

Q: What is Nisha Bertucci's NPI number?

The NPI number for Nisha Bertucci is 1215170766. It was assigned to this individual provider in the NPPES registry on April 14, 2009. The provider is also known as Dr. Nisha Kamalesh Shastri M.D..

Q: What is Nisha Bertucci's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Nisha Bertucci was last updated on March 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 14, 2009PECOS EnrolledAccepts Medicare Assignment

86.44/100

CMS Quality Rating

330 BARCLAY AVE NE STE 304, GRAND RAPIDS, MI 49503(616) 391-2160 Get Directions Write a Review

NPPES record last updated: March 4, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 4, 2021, Nov 9, 2020, May 18, 2018 and 1 more (4 updates tracked since 2015).

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About Dr. Nisha Shastri Bertucci M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NISHA SHASTRI BERTUCCI M.D. (NPI 1215170766) is an individual obstetrics & gynecology provider in Grand Rapids, Michigan, licensed in Michigan (4301094756) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Michigan State University College Of Human Medicine (2009).

NPPES Registry Identity

NPI1215170766

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameDR. NISHA SHASTRI BERTUCCICredential: M.D.

Location Address330 BARCLAY AVE NE STE 304Grand Rapids, MI 49503-2527

Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560

Phone(616) 391-2160

Sole ProprietorNo

Medical School CMSMichigan State University College Of Human MedicineGraduated 2009

Enumeration DateApril 14, 2009

Last NPPES UpdateMarch 4, 20214 updates tracked since enumeration

NPPES CertifiedMarch 4, 2021

✔ NPI 1215170766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in MI · 4301094756

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

330 BARCLAY AVE NE STE 304, Grand Rapids, MI 49503

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Other Names 1

Former Name (1)Dr. Nisha Kamalesh Shastri M.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nisha Shastri Bertucci M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658522123

PECOS Enrollment IDI20131008001565

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.44/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

81.93

Promoting Interoperability

100

Improvement Activities

Cost

41.91

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAELA BROWN MD

Obstetrics & Gynecology