DESIREE M BERTILRUD (NP) – Nurse Practitioner, NPI 1164603460

DESIREE M BERTILRUD (NP) is a healthcare provider. based in Thief river falls, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. R156913-9 (MN). The NPI Number for DESIREE M BERTILRUD (NP) is 1164603460

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
DESIREE M BERTILRUD (NP)
NPI
1164603460
Phone
(218) 681-4747
Address
1720 HIGHWAY 59 S
Enumeration Date
15 November 2007
Last Update Date
25 January 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2186832725
Graduation Year
2007 (19 years ago)
PAC ID
5092896019
Group Practice PAC ID
8022206663
Professional Enrollment ID
I20080116000342
Address ID
MN567012700TH3001XPKWY300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for DESIREE M BERTILRUD (NP)

  • 1720 HIGHWAY 59 S

    THIEF RIVER FALLS, MN 567014331

    Phone: (218) 681-4747

    Fax: (218) 683-2595

    Mailing address matches the actual address.

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: 2008-01-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080116000342INurse PractitionerMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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 56701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022206663View full group profile
NameSpecialtyState
-MN
-MN
Clinical Social WorkerSD
Interventional Pain Management, Pain Management, Anesthesiology, Critical Care (Intensivists), Internal MedicineND
Nurse PractitionerMN
O B S T E T R I C S/ G Y N E C O L O G YMN
Nurse PractitionerMN
Family PracticeND
Family PracticeSD
Internal MedicineMN

Reviews

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Frequently asked questions

Can I cross-check DESIREE M BERTILRUD (NP) using NPI 1164603460?
NPI 1164603460 belongs to DESIREE M BERTILRUD (NP); compare other details if you need extra assurance.
Is DESIREE M BERTILRUD (NP) still an active registrant?
DESIREE M BERTILRUD (NP) carries an active NPI according to the public dataset.
How would a patient describe DESIREE M BERTILRUD (NP)'s focus?
For DESIREE M BERTILRUD (NP), the primary taxonomy reads as Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DESIREE M BERTILRUD (NP)?
Travel planning: use Thief River Falls, Minnesota as the reference point for DESIREE M BERTILRUD (NP), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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