Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MICHAEL BERTOLIO DO
NPI 1679348775
Student in an Organized Health Care Education/Training Program in Memphis, TN

Q: What is Michael Bertolio's NPI number?

The NPI number for Michael Bertolio is 1679348775. It was assigned to this individual provider in the NPPES registry on November 17, 2023.

Q: What is Michael Bertolio's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Bertolio was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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 November 17, 2023PECOS Enrolled

920 MADISON AVE # 447, MEMPHIS, TN 38103(435) 512-0612 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 29, 2026, Nov 17, 2023 (2 updates tracked since 2023).

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About Dr. Michael Bertolio Do NPPES

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

DR. MICHAEL BERTOLIO DO (NPI 1679348775) is an individual student in an organized health care education/training program in Memphis, Tennessee and active in the NPI registry since November 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679348775

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. MICHAEL BERTOLIOCredential: DO

Location Address920 MADISON AVE # 447Memphis, TN 38103-3438

Mailing Address920 Madison Ave # 447Memphis, TN 38103-3438 · (435) 512-0612

Phone(435) 512-0612

Sole ProprietorYes

Enumeration DateNovember 17, 2023

Last NPPES UpdateSeptember 29, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2026

✔ NPI 1679348775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

920 MADISON AVE # 447, Memphis, TN 38103

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Michael Bertolio Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 7

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

GWYNETH A SULLIVAN

Student in an Organized Health Care Education/Training Program