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MR. SAMUEL MARK BERTOCH FNP-C
NPI 1417525544
Nurse Practitioner in Roosevelt, UT

Active since June 15, 2021PECOS EnrolledAccepts Medicare Assignment
99.76/100
CMS Quality Rating
2750 NORTH 2762 WEST, ROOSEVELT, UT 84066(435) 722-9250 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Samuel Mark Bertoch Fnp-c NPPES

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

MR. SAMUEL MARK BERTOCH FNP-C (NPI 1417525544) is an individual nurse practitioner in Roosevelt, Utah, licensed in Utah (327174-4405) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS, is affiliated with Uintah Basin Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1417525544
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMR. SAMUEL MARK BERTOCHCredential: FNP-C
Location Address2750 NORTH 2762 WESTRoosevelt, UT 84066
Mailing Address2750 North 2762 WestRoosevelt, UT 84066 · (435) 722-9250
Phone(435) 722-9250
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJune 15, 2021
NPPES CertifiedApril 2, 2021
✔ NPI 1417525544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in UT · 327174-4405
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
2750 NORTH 2762 WEST, Roosevelt, UT 84066
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, Select Health.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

Mr. Samuel Mark Bertoch Fnp-c 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 ID7810392271
PECOS Enrollment IDI20210823002405
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
540 services47 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
201 services80 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
133 services64 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
104 services25 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
70 services46 patients
Injection of trigger points, 3 or more muscles 20553
Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.
16 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Uintah Basin Medical Center

Acute Care Hospitals · Roosevelt, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number460019
Location250 West 300 NorthRoosevelt, UT 84066 · Duchesne County
Emergency services Birthing friendly

Ashley Regional Medical Center

Acute Care Hospitals · Vernal, UT
OwnershipProprietary
CMS Certification Number460030
Location150 West 100 NorthVernal, UT 84078 · Uintah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84066 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

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.

99.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability100
Improvement Activities40
Cost99.21

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 Samuel Bertoch's NPI number?

The NPI number for Samuel Bertoch is 1417525544. It was assigned to this individual provider in the NPPES registry on June 15, 2021.

Where is Samuel Bertoch located?

Samuel Bertoch practices at 2750 North 2762 West, Roosevelt, UT 84066. The listed phone number is (435) 722-9250.

What is Samuel Bertoch's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Samuel Bertoch enrolled in Medicare?

Yes. Samuel Bertoch 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.

What insurance does Samuel Bertoch accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health list Samuel Bertoch as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samuel Bertoch affiliated with any hospitals?

According to CMS data, Samuel Bertoch is affiliated with Uintah Basin Medical Center and Ashley Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Samuel Bertoch was last updated on June 15, 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.