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DR. JERRY RUSSELL BARTLESON M.D.
NPI 1386686376
Emergency Medicine in Tully, NY

Active since June 12, 2006PECOS EnrolledAccepts Medicare Assignment
7434 SONG LAKE RD, TULLY, NY 13159(315) 569-6329(315) 696-5539 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 26, 2026, Jan 19, 2026 (2 updates tracked since 2026).

About Dr. Jerry Russell Bartleson M.d. NPPES

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

DR. JERRY RUSSELL BARTLESON M.D. (NPI 1386686376) is an individual emergency medicine provider in Tully, New York, licensed in New York (163749) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Lakewood Health Center, and maintains a secondary practice location in Renovo.

NPPES Registry Identity

NPI1386686376
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. JERRY RUSSELL BARTLESONCredential: M.D.
Location Address7434 SONG LAKE RDTully, NY 13159-9211
Mailing Address7434 Song Lake RdTully, NY 13159-9211 · (315) 569-6329 · Fax (315) 696-5539
Phone(315) 569-6329
Fax(315) 696-5539
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateJune 12, 2006
Last NPPES UpdateJanuary 26, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2026
✔ NPI 1386686376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in NY · 163749✔ Licensed in MN · 31435✔ Licensed in WI · 28860✔ Licensed in PA · MD446096
Definition
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.
7434 SONG LAKE RD, Tully, NY 13159
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Secondary Practice Location 1

Location 11001 Pine StRenovo, PA 17764-1620 · Phone (570) 923-1000 · Fax (570) 923-0118

Other Identifiers 3

Medicaid981088900MN
Medicaid31522700WI
Medicaid163749NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jerry Russell Bartleson 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 ID42102667
PECOS Enrollment IDI20040625000032
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.

Medicare Billing Reassignments

7

Medicare enrollment records show Jerry Bartleson reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Barnes-Kasson County Hospital
59 mi
Multi-Specialty
25059 STATE ROUTE 11
Hallstead, PA 18822
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Also billed through NPI 1932138161 (Pennsylvania)
  • 19 clinicians in this Medicare group
NPI 1720573918 (570) 853-3135
Bucktail Medical Center
129 mi
Critical Access
1001 PINE ST
Renovo, PA 17764
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 21 clinicians in this Medicare group
NPI 1821083700 (570) 923-1000
Provider Profile
150 mi
Emergency Medicine
1927 SARANAC AVE, SUITE 100
Lake Placid, NY 12946
  • Reassigned Medicare billing, New York enrollment
  • 16 clinicians in this Medicare group
NPI 1962472514 (518) 523-7575
Dlp Conemaugh Physician Practices LLC
199 mi
Rural Health
564 THEATRE RD
Carrolltown, PA 15722
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 771 clinicians in this Medicare group
NPI 1558777995 (814) 344-8477
Cook County Hospital District
772 mi
Critical Access
515 5TH AVE W
Grand Marais, MN 55604
  • Reassigned Medicare billing, Minnesota enrollment
  • 81 clinicians in this Medicare group
NPI 1487712493 (218) 387-3040
Keokuk County Health Center
830 mi
Rural Health
23019 HIGHWAY 149
Sigourney, IA 52591
  • Reassigned Medicare billing, Iowa enrollment
  • 45 clinicians in this Medicare group
NPI 1073898649 (641) 622-2720
Lakewood Health Center
979 mi
Critical Access
600 MAIN AVE S
Baudette, MN 56623
  • Reassigned Medicare billing, Minnesota enrollment
  • 27 clinicians in this Medicare group
NPI 1922072776 (218) 634-2120

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

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

Lakewood Health Center

Critical Access Hospitals · Baudette, MN
OwnershipVoluntary non-profit - Church
CMS Certification Number241301
Location600 Main Ave SBaudette, MN 56623 · Lake Of Woods County
Emergency services

North Shore Health

Critical Access Hospitals · Grand Marais, MN
OwnershipGovernment - Hospital District or Authority
CMS Certification Number241317
Location515 5th Ave WestGrand Marais, MN 55604 · Cook County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13159 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Bartleson's NPI number?

The NPI number for Jerry Bartleson is 1386686376. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Jerry Bartleson located?

Jerry Bartleson practices at 7434 Song Lake Rd, Tully, NY 13159. The listed phone number is (315) 569-6329.

What is Jerry Bartleson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Jerry Bartleson enrolled in Medicare?

Yes. Jerry Bartleson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jerry Bartleson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jerry Bartleson reassigns Medicare benefits to 7 organizations: Barnes-Kasson County Hospital (Hallstead, PA), Bucktail Medical Center (Renovo, PA), (Lake Placid, NY), Dlp Conemaugh Physician Practices LLC (Carrolltown, PA), Cook County Hospital District (Grand Marais, MN) and 2 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jerry Bartleson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jerry Bartleson affiliated with any hospitals?

According to CMS data, Jerry Bartleson is affiliated with Lakewood Health Center and North Shore Health.

When was this NPI record last updated?

The NPPES record for Jerry Bartleson was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.