Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Samuel Mark Bertoch, FNP-C

Individual provider Nurse Practitioner · NPI 1417525544

Mr. Samuel Mark Bertoch, FNP-C is a Nurse Practitioner in Roosevelt, Utah. Qualified in 2021, 5 years ago. Practices with Northeastern Utah Medical Group, a 51-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
5
Licensed in
UT
In the registry since
2021
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

2750 N 2762 W
Roosevelt, UT 84066
Phone: (435) 722-9250
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 327174-4405 (UT)

Record details

NPI number1417525544
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedJune 15, 2021
Last updated in NPPESJune 15, 2021
Certification dateApril 2, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northeastern Utah Medical Group — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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