MR. SAMUEL MARK BERTOCH (FNP-C) – Nurse Practitioner, NPI 1417525544
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,655 NURSE PRACTITIONER in UT
Provider Addresses for MR. SAMUEL MARK BERTOCH (FNP-C)
2750 NORTH 2762 WEST
ROOSEVELT, UT 84066
Phone: (435) 722-9250
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 2 Open Payments records for all available years, with a total value of $119.
Total Amount is formed as General ($119) + Research ($0) + Ownership ($0) = $119.
Last reported payment date: 2024-04-19 • Largest payer in this snapshot: Globus Medical, Inc. ($70).
Total Amount
$119
General + Research + Ownership
Payments
2
Total payment records
General Amount
$119
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Globus Medical, Inc. | $70 |
| ABBVIE INC. | $50 |
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: 2021-08-23
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 |
|---|---|---|---|---|
| I20210823002405 | I | Nurse Practitioner | UT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 318 | 39 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 310 | 108 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 245 | 24 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 160 | 92 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 81 | 38 | $0 |
Insurance plans in this area (ZIP 84066)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| Physician Assistant | UT | |
| General Surgery | UT | |
| H E M A T O L O G Y/ O N C O L O G Y | GA | |
| Medical Oncology, Hematology/Oncology, Internal Medicine | UT | |
| - | UT | |
| Internal Medicine | UT | |
| Physical Medicine And Rehabilitation | UT | |
| O T O L A R Y N G O L O G Y | CO | |
| Family Practice | UT |
Reviews
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