PHILLIP D BERTRAM MD
NPI 1487648507
Internal Medicine - Gastroenterology in Cookeville, TN

Q: What is Phillip Bertram's NPI number?

The NPI number for Phillip Bertram is 1487648507. It was assigned to this individual provider in the NPPES registry on September 2, 2005.

Q: What is Phillip Bertram's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Phillip Bertram was last updated on May 26, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 02, 2005PECOS EnrolledAccepts Medicare Assignment

438 N WHITNEY AVE, COOKEVILLE, TN 38501(931) 783-2616(931) 783-2610 Get Directions Write a Review

NPPES record last updated: May 26, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 26, 2022, May 15, 2017 (2 updates tracked since 2017).

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About Phillip D Bertram Md NPPES

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

PHILLIP D BERTRAM MD (NPI 1487648507) is an individual gastroenterology provider in Cookeville, Tennessee, licensed in Tennessee (6496) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Cookeville Regional Medical Center, and is a graduate of Other (1968).

NPPES Registry Identity

NPI1487648507

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NamePHILLIP D BERTRAMCredential: MD

Location Address438 N WHITNEY AVECookeville, TN 38501-2455

Mailing Address140 W 7th StCookeville, TN 38501-1726 · (931) 783-5582 · Fax (931) 526-6760

Phone(931) 783-2616

Fax(931) 783-2610

Sole ProprietorNo

Medical School CMSOtherGraduated 1968

Enumeration DateSeptember 2, 2005

Last NPPES UpdateMay 26, 20222 updates tracked since enumeration

NPPES CertifiedMay 26, 2022

✔ NPI 1487648507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in TN · 6496

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

438 N WHITNEY AVE, Cookeville, TN 38501

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Other Identifiers 3

Medicaid64790702KY

Medicaid3154324TN

Other4212762TN · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia 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

Phillip D Bertram Md 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 ID9032013701

PECOS Enrollment IDI20040109000837

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 7

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.

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.

261 services194 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

128 services128 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

62 services62 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

52 services50 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

45 services41 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.

43 services42 patients

Hospital Affiliations CMS Care Compare

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

Cookeville Regional Medical Center

Acute Care Hospitals · Cookeville, TN

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number440059

Location1 Medical Center BoulevardCookeville, TN 38501 · Putnam County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38501 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

9%343 patients1/55-star benchmark: 92%

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

4%640 patients1/55-star benchmark: 100%

Cervical Cancer Screening

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…

3%314 patients

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

72%43 patients3/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

98%1,503 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

95%1,766 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

36%1,097 patients2/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

93%681 patients3/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

51%1,849 patients3/55-star benchmark: 97%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

17%620 patients1/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

24%1,352 patients2/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 96% · 188 patients

Patients tobacco: 9% · 23 patients

84%188 patients4/55-star benchmark: 98%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

69%188 patients3/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

96%1,849 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

5%1,849 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

14%1,849 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 10

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

DONNA J WINNINGHAM APN

Clinical Nurse Specialist (Family Health)

438 N WHITNEY AVE, SUITE 2
COOKEVILLE, TN 38501

Putnam County (931) 528-2557

JOYCE F BREMER M.D.

Internal Medicine (Gastroenterology)