Active NPI
Kenneth R Bernal, DO
- Family Medicine Physician
- Rockwall, TX
National Provider Identifier
1023087434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H2245
- Practice address
- 2265 N Lakeshore Dr Ste 101
Rockwall, TX 75087-3210 - Phone
- (972) 771-2500
- Fax
- (972) 722-4550
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H2245 | TX | Primary |
Addresses
Primary practice location
2265 N Lakeshore Dr Ste 101
Rockwall, TX 75087-3210
Mailing address
2265 N Lakeshore Dr Ste 101
Rockwall, TX 75087-3210
Phone (972) 771-2500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121379506 | Medicaid | TX | |
| 121379505 | Medicaid | TX | |
| 1213379507 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2265 N Lakeshore Dr
Suite 101
Rockwall, TX 75087-3210
Phone (972) 771-2500
Hospital & facility affiliations
- Accentcare Home Health of McKinney
- Texas Health Presbyterian Hospital Rockwall
- Baylor Scott and White Medical Center Lake Pointe
- Texas Health Presbyterian Hospital Dallas
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Health Physicians Group | Current | Accepting new patients |
Interoperability endpoints
- kbernal65241@direct.texashealth.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1174573596
-
- Sleep Disorder Diagnostic Clinic/Center
- Fort Worth, TX
- NPI 1114395969
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Orthopaedic Surgery of the Spine Physician
- Plano, TX
- NPI 1184663163
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Richardson, TX
- NPI 1114035383
Hospital
-
- General Acute Care Hospital
- Rowlett, TX
- NPI 1205018439
-
- General Acute Care Hospital
- Rockwall, TX
- NPI 1629138029
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1396779948
-
- Home Health Agency
- McKinney, TX
- NPI 1639609084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1023087434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2265 N LAKESHORE DR STE 101",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750873210",
"telephone_number": "972-771-2500",
"fax_number": "972-722-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2265 N LAKESHORE DR STE 101",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750873210",
"telephone_number": "972-771-2500",
"fax_number": "972-722-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNAL",
"first_name": "KENNETH",
"middle_name": "R",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H2245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121379506",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121379505",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1213379507",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.