Jeremia Douglas Bernhardt, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ML20008810 Issued in WA

Practice address

1401 Madison St
Suite 100
Seattle, WA 98104-1316

Phone

(206) 386-6111

Fax

(206) 386-6113

NPI assigned

Apr 13, 2007

Last updated

Apr 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbernhardt1037402@wm.providencedirect.org

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Iora Health Massachusetts, P.C.

  dba One Medical

  • Internal Medicine Physician
  • Hyannis, MA
  • NPI 1851858666
  NPD (past)
• Iora Health, LLC

  dba One Medical at Dartmouth

  • Internal Medicine Physician
  • Hanover, NH
  • NPI 1700285616
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1073738373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15721 ASHWORTH AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335732",
            "telephone_number": "571-232-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MADISON ST",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041316",
            "telephone_number": "206-386-6111",
            "fax_number": "206-386-6113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 16th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981225636",
            "country_code": "US",
            "telephone_number": "206-320-2484",
            "fax_number": "206-320-4568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNHARDT",
        "first_name": "JEREMIA",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML20008810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbernhardt1037402@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 16th Ave Ste 100",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981225636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Candace Lyn Bernd, MA CCC-SLP
• Daniel Scott Berndt
• Jennifer Edith Berndt
• Samantha Lynne Bernecker, PHD
• Lynsey Michelle Eider Bernfeld, MD
• Linda Bernhardt
• Michael Hawthorne Berni, MED
• Raphael A Bernier, PHD
• Bonnie L. Bernstein, CNM, ARNP
• Erin R Bernstein, CRNA

• Family Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.