DR. JERRY RUSSELL BARTLESON (M.D.) – Emergency Medicine Physician, NPI 1386686376
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,391 EMERGENCY MEDICINE in PA
Provider Addresses for DR. JERRY RUSSELL BARTLESON (M.D.)
1001 Pine St
Renovo, PA 177641620
Phone: (570) 923-1000
Fax: (570) 923-0118
Type: Location
7434, Song Lake Road, Town of Tully, Cortland County, New York, 13159, United States
TULLY, NY 131599211
Phone: (315) 569-6329
Fax: (315) 696-5539
Type: Mailing
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: 2021-04-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20040329000277 | I | Emergency Medicine | NY | TBD |
| I20040625000032 | I | Emergency Medicine | MN | TBD |
| I20180518000400 | I | Emergency Medicine | PA | TBD |
| I20210407001154 | I | Emergency Medicine | IA | 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 17764)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Hospitalist | MN | |
| Hospitalist, Hospitalist, Internal Medicine | SD | |
| Emergency Medicine, Family Practice, Family Practice, Emergency Medicine | MN | |
| Emergency Medicine | NC | |
| Internal Medicine, Hospitalist | NC | |
| Emergency Medicine | TX | |
| Hospitalist, Internal Medicine | MN | |
| H O S P I T A L I S T | MN | |
| Emergency Medicine | MINNESOTA |
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