Individual provider Active NPI

Edmund A Bermudez, M.D.

  • Interventional Cardiology Physician
  • North Venice, FL
National Provider Identifier
1073636197
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME98576 Issued in FL
Practice address
200 Healthcare Way
Suite 202
North Venice, FL 34275-3669
Phone
(941) 261-0160
Fax
(941) 261-0165
NPI assigned
Apr 6, 2007
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME98576 FL
Interventional Cardiology Physician 207RI0011X ME98576 FL Primary

Addresses

Primary practice location

200 Healthcare Way
Suite 202
North Venice, FL 34275-3669

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

600 Nokomis Ave S Ste 102&203
Venice, FL 34285
Phone (941) 486-6979

Other identifiers 5

IdentifierTypeStateIssuer
7173488OtherFLAETNA
P00417656OtherFLRAILROAD MEDICARE
09083OtherFLBLUE CROSS BLUE SHIELD
9430897OtherFLCIGNA
279605800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070920000652 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Peripheral Vascular Disease 2466359278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Peripheral Vascular Disease
Education
Michigan State University College of Human Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

200 Healthcare Way
Suite 202
North Venice, FL 34275-3670
Phone (941) 261-0200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting13
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc CurrentSince Nov 1, 2021 Accepting new patients
Lahey Clinic, Inc Past Accepting new patients
SMH Physician Services Inc PastSince Nov 1, 2021 Accepting new patients
Lahey Clinic, Inc. Past Accepting new patients
Florida Cardiac Consultants, Inc Interventional Cardiology PastSince Aug 13, 2007 Accepting new patients

Locations

200 Healthcare Way
Ste 202
North Venice, FL 34275
Phone (941) 261-0160

200 Healthcare Way
Unit 101
North Venice, FL 34275
Phone (941) 261-0160

200 Healthcare Way
Unit 103
North Venice, FL 34275
Phone (941) 261-0160

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: edmund.bermudez@fpg.directbygreenway.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1073636197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTHCARE WAY",
            "address_2": "SUITE 202",
            "city": "NORTH VENICE",
            "state": "FL",
            "postal_code": "342753669",
            "telephone_number": "941-261-0160",
            "fax_number": "941-261-0165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Nokomis Ave S Ste 102&203",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "34285",
            "country_code": "US",
            "telephone_number": "941-486-6979",
            "fax_number": "941-486-6964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "EDMUND",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2021-11-08",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME98576",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME98576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7173488",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00417656",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09083",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9430897",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279605800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Venice, FL

Sources for this page

Verify at the official NPI Registry.