1. Home
  2. Directory
  3. Ohio
  4. Wright Patterson Afb
  5. Pediatrics
  6. NPI Profile

THOMAS MARK BERTAGNOLI D.O.
NPI 1912394776
Pediatrics in Wright Patterson Afb, OH

Active since April 20, 2015PECOS Enrolled
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433(937) 257-9612 Get Directions Write a Review

NPPES record last updated: August 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 25, 2022, Jul 16, 2019, Jul 3, 2018 (3 updates tracked since 2018).

About Thomas Mark Bertagnoli D.o. NPPES

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

THOMAS MARK BERTAGNOLI D.O. (NPI 1912394776) is an individual pediatrics provider in Wright Patterson Afb, Ohio, licensed in Nebraska (1611) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912394776
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameTHOMAS MARK BERTAGNOLICredential: D.O.
Location Address4881 SUGAR MAPLE DRWright Patterson Afb, OH 45433-5529
Mailing Address88mdg/sghj, 4881 Sugar Maple DrWright-patterson Afb, OH 45433-5529
Phone(937) 257-9612
Sole ProprietorYes
Enumeration DateApril 20, 2015
Last NPPES UpdateAugust 3, 20233 updates tracked since enumeration
NPPES CertifiedAugust 1, 2023
✔ NPI 1912394776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NE · 1611
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
4881 SUGAR MAPLE DR, Wright Patterson Afb, OH 45433
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas Mark Bertagnoli D.o. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45433 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

MR. JAMES REBELLO III
Pharmacist
4881 SUGAR MAPLE DR
FAIRBORN, OH 45433
Greene County (937) 257-9014
CARLA HUELSKAMP PHARMD
Pharmacist
4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-9696
JOHN ALAN ARTHUR
Internal Medicine
4881 SUGAR MAPLE DR
WPAFB, OH 45433
Greene County (937) 257-4482
ALEXIS D OWEN
Military Health Care Provider (Independent Duty Medical Technicians)
4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-1574
GREGORY JAMES MORSE M.D.
Radiology (Nuclear Radiology)
4881 SUGAR MAPLE DR, 88 DTS/SGQX
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-9679
KENDRA M. SCHMUCK RD LD
Dietitian, Registered
4881 SUGAR MAPLE DR
WPAFB, OH 45433
Greene County (937) 257-8815
MATTHEW PHILIP SCULLY IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB, OH 45433
Greene County (616) 717-0169
KAREN LEWIS RTT
Radiologic Technologist (Radiation Therapy)
4881 SUGAR MAPLE DR, 88TH MDOS/SGOMR
WRIGHT PATTERSON AFB, OH 45433
Greene County (937) 257-4159

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 Thomas Bertagnoli's NPI number?

The NPI number for Thomas Bertagnoli is 1912394776. It was assigned to this individual provider in the NPPES registry on April 20, 2015.

Where is Thomas Bertagnoli located?

Thomas Bertagnoli practices at 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433. The listed phone number is (937) 257-9612.

What is Thomas Bertagnoli's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Thomas Bertagnoli enrolled in Medicare?

Yes. Thomas Bertagnoli is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Thomas Bertagnoli was last updated on August 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.