DR. NISHA SHASTRI BERTUCCI (M.D.) – Obstetrics & Gynecology Physician, NPI 1215170766
Obstetrics & Gynecology Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,735 OBSTETRICS/GYNECOLOGY in MI
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Provider Addresses for DR. NISHA SHASTRI BERTUCCI (M.D.)
Spectrum Health Butterworth Hospital, 100, Michigan Street Northeast, Grand Rapids, Kent County, Michigan, 49503, United States
MC 845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
304, Barclay Avenue Northeast, Heritage Hill Historic District, Grand Rapids, Kent County, Michigan, 49503, United States
GRAND RAPIDS, MI 495032527
Phone: (616) 391-2160
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-10-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131008001565 | I | Obstetrics/Gynecology | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| General Surgery, Critical Care (Intensivists) | MI | |
| Pediatric Medicine | MI | |
| - | MI | |
| - | MI | |
| Hand Surgery | MN | |
| - | MI | |
| - | MI | |
| Internal Medicine | MI | |
| - | MI |
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