Individual provider Active NPI

Michael H Bernstein, MD

  • Surgery Physician
  • Wayne, NJ
National Provider Identifier
1073540613
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA02536600 Issued in NJ
Practice address
220 Hamburg Tpke Ste 2
Wayne, NJ 07470
Phone
(973) 790-8094
Fax
(973) 790-8095
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA02536600 NJ Primary

Addresses

Primary practice location

220 Hamburg Tpke Ste 2
Wayne, NJ 07470

Mailing address

220 Hamburg Tpke
Ste 2
Wayne, NJ 07470-2151
Phone (973) 790-8094

Other practice location 1

220 Hamburg Tpke
Ste 2
Wayne, NJ 07470-2151
Phone (973) 790-8094

Other identifiers 1

IdentifierTypeStateIssuer
2817403MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080603000065 NJ Practitioner - General Surgery 7911077979 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Marriott Medical Corp Surgery CurrentSince Feb 11, 2019 Accepting new patients
Robert Marriott Medical Corp Surgery CurrentSince Feb 11, 2019 Accepting new patients
Erwin Douyon, MD, PC Surgery Past Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

1048 Grove St
Elizabeth, NJ 07202
Phone (732) 967-0100

94 Stevens Rd
Toms River, NJ 08755
Phone (732) 286-5005

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1073540613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE",
            "address_2": "STE 2",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702151",
            "telephone_number": "973-790-8094",
            "fax_number": "973-790-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE STE 2",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-790-8094",
            "fax_number": "973-790-8095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 HAMBURG TPKE",
            "address_2": "STE 2",
            "address_purpose": "LOCATION",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702151",
            "country_code": "US",
            "telephone_number": "973-790-8094",
            "fax_number": "973-790-8095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA02536600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2817403",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.