Active NPI
Dean H Bernacchia, MD
- Urology Physician
- Medina, OH
National Provider Identifier
1073725354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 35025014B
- Practice address
- 4366 Lakeview Glen Drive
Medina, OH 44256-6513 - Phone
- (330) 721-2774
- NPI assigned
- May 7, 2007
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 35025014B | OH | Primary |
Addresses
Primary practice location
4366 Lakeview Glen Drive
Medina, OH 44256-6513
Mailing address
4366 Lakeview Glen Drive
Medina, OH 44256-6513
Phone (330) 721-2774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0406868 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35025014B | OH | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073725354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4366 LAKEVIEW GLEN DRIVE",
"city": "MEDINA",
"state": "OH",
"postal_code": "442566513",
"telephone_number": "330-721-2774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4366 LAKEVIEW GLEN DRIVE",
"city": "MEDINA",
"state": "OH",
"postal_code": "442566513",
"telephone_number": "330-721-2774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNACCHIA",
"first_name": "DEAN",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OH",
"license": "35025014B",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0406868",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.