Individual provider Active NPI

Eduardo Brown Bermudez, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Rochester, NY
National Provider Identifier
1083060602
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 275-3274
NPI assigned
May 12, 2016
Last updated
May 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

63 Plymouth Ave N
63
Rochester, NY 14614-1277
Phone (404) 426-0962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210211000154 CA Practitioner - Physical Medicine and Rehabilitation 1951641075 Reassigns benefits to 1 organization
Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Morehouse School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

630 Alhambra Blvd
Sacramento, CA 95816-3806
Phone (916) 440-9652

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Jul 23, 2023 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jul 23, 2023 Accepting new patients
Dignity Health Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2120 Professional Dr
Roseville, CA 95661
Phone (916) 631-3010

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

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, 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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1083060602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 PLYMOUTH AVE N",
            "address_2": "63",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146141277",
            "telephone_number": "404-426-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "EDUARDO",
        "middle_name": "BROWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.