Individual provider Active NPI

Charles M Bernstein, MD

  • Internal Medicine Physician
  • Edgewood, KY
National Provider Identifier
1053302018
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39184 Issued in KY
Practice address
1 Medical Village Dr
St. Elizabeth Healthcare
Edgewood, KY 41017
Phone
(859) 301-2423
Fax
(859) 301-2066
NPI assigned
Oct 31, 2005
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35069035 OH
Internal Medicine Physician 207R00000X 39184 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
St. Elizabeth Healthcare
Edgewood, KY 41017

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000427 KY Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 1052365384 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35069035OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jul 29, 2014 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Jan 9, 2011 Accepting new patients
Summit Medical Group, Inc Internal Medicine CurrentSince Jul 29, 2014 Accepting new patients
St Elizabeth Medical Center, Inc Internal Medicine CurrentSince Jan 9, 2011 Accepting new patients
Deaconess Healthcare Services Co Internal Medicine Past Accepting new patients
Palliative Care Center of the Bluegrass Inc. Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Locations

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Interoperability endpoints

  • Direct secure messaging: cbernstein167257@direct-prd.stelizabeth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1053302018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "address_2": "ST. ELIZABETH HEALTHCARE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-2423",
            "fax_number": "859-301-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35069035",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "39184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.