HOLLY BERTHOD (APRN) – Women's Health Nurse Practitioner, NPI 1053903443

HOLLY BERTHOD (APRN) is a healthcare provider. based in Pascoag, Rhode Island. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN02465 (RI). The NPI Number for HOLLY BERTHOD (APRN) is 1053903443

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY BERTHOD (APRN)
NPI
1053903443
Phone
(401) 744-3374
Address
99 PASCOAG MAIN ST
Enumeration Date
7 February 2021
Last Update Date
23 June 2021

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4014906464
Graduation Year
2020 (6 years ago)
PAC ID
0143699728
Group Practice PAC ID
0042486649
Professional Enrollment ID
I20221205001251
Address ID
RI029085720PR297XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,473 NURSE PRACTITIONER in RI

Provider Addresses for HOLLY BERTHOD (APRN)

  • 99 PASCOAG MAIN ST

    PASCOAG, RI 028593103

    Phone: (401) 744-3374

    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)

CMS reports 34 Open Payments records for all available years, with a total value of $737.

Total Amount is formed as General ($737) + Research ($0) + Ownership ($0) = $737.

Last reported payment date: 2024-12-21 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($181).

Total Amount

$737

General + Research + Ownership

Payments

34

Total payment records

General Amount

$737

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-21

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2022-12-05

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
I20221205001251INurse PractitionerRITBD

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 02859)

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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: 0042486649View full group profile
NameSpecialtyState
-RI
O B S T E T R I C S/ G Y N E C O L O G YRI
-RI
O B S T E T R I C S/ G Y N E C O L O G YRI
O B S T E T R I C S/ G Y N E C O L O G YRI
O B S T E T R I C S/ G Y N E C O L O G YRI
O B S T E T R I C S/ G Y N E C O L O G YRI
O B S T E T R I C S/ G Y N E C O L O G YRI
O B S T E T R I C S/ G Y N E C O L O G YRI
O B S T E T R I C S/ G Y N E C O L O G YRI

Reviews

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Frequently asked questions

Can I cross-check HOLLY BERTHOD (APRN) using NPI 1053903443?
NPI 1053903443 belongs to HOLLY BERTHOD (APRN); compare other details if you need extra assurance.
Would HOLLY BERTHOD (APRN) appear as active to a payer?
You can treat HOLLY BERTHOD (APRN) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with HOLLY BERTHOD (APRN)?
HOLLY BERTHOD (APRN)'s record emphasizes Women's Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for HOLLY BERTHOD (APRN)?
Travel planning: use Pascoag, Rhode Island as the reference point for HOLLY BERTHOD (APRN), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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