MEDICARE: GINA MARIE BARTLETT PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	MA067571	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16779158	OTHER		CAQH

General Provider Information

NPI Number	:	1609726611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA MARIE BARTLETT PA-C

Provider Business Mailing Address
First Line	:	2580 HAYMAKER RD STE 304
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-3500
Country	:	US
Telephone Number	:	412-858-3070
Fax Number	:

Provider Business Practice Location Address
First Line	:	2580 HAYMAKER RD STE 304
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-3500
Country	:	US
Telephone Number	:	412-858-3070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	04/08/2026

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