| Dr Jerry Russell Bartleson, MD | |
|
7434 Song Lake Rd, Tully, NY 13159-9211 | |
| (315) 696-5539 | |
| (315) 696-5539 |
| Full Name | Dr Jerry Russell Bartleson |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 42 Years |
| Location | 7434 Song Lake Rd, Tully, New York |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386686376 | NPI | - | NPPES |
| 31522700 | Medicaid | WI | |
| 163749 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 163749 (New York) | Primary |
| 207P00000X | Emergency Medicine | 31435 (Minnesota) | Secondary |
| 207P00000X | Emergency Medicine | 28860 (Wisconsin) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| North Shore Health | Grand marais, MN | Hospital |
| Lakewood Health Center | Baudette, MN | Hospital |
| Bucktail Medical Center | Renovo, PA | Hospital |
| Lake View Memorial Hospital | Two harbors, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cook County Hospital District | 4284629742 | 6 |
| Lakewood Health Center | 5698687929 | 10 |
| Bucktail Medical Center | 6800852112 | 5 |
| Entity Name | Lakewood Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972799237 PECOS PAC ID: 5698687929 Enrollment ID: O20031104000469 |
| Entity Name | Cook Area Health Services, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174596027 PECOS PAC ID: 4880681303 Enrollment ID: O20040427001470 |
| Entity Name | Swift County-benson Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174529002 PECOS PAC ID: 8729069281 Enrollment ID: O20040528001145 |
| Entity Name | Cook County Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487712493 PECOS PAC ID: 4284629742 Enrollment ID: O20050906000732 |
| Entity Name | Lakewood Health Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1922072776 PECOS PAC ID: 5698687929 Enrollment ID: O20080118000179 |
| Entity Name | Cook County Hospital District |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1487712493 PECOS PAC ID: 4284629742 Enrollment ID: O20091207000102 |
| Entity Name | Carris Health - Redwood Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265914048 PECOS PAC ID: 7911259619 Enrollment ID: O20181129001082 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jerry Russell Bartleson, MD 7434 Song Lake Rd, Tully, NY 13159-9211 Ph: (315) 696-5539 | Dr Jerry Russell Bartleson, MD 7434 Song Lake Rd, Tully, NY 13159-9211 Ph: (315) 696-5539 |
Gregory Scott Steencken, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: Po Box 341, Tully, NY 13159 Phone: 315-707-8050 Fax: 315-227-0570 |