Active NPI
Patricia A Bermudez, MD
- General Practice Physician
- Dearborn, MI
National Provider Identifier
1114125382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 016364
- Practice address
- 1315 Robindale Ave
Dearborn, MI 48128-1012 - Phone
- (331) 390-3469
- NPI assigned
- Jul 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 016364 | PR | Primary |
Addresses
Primary practice location
1315 Robindale Ave
Dearborn, MI 48128-1012
Mailing address
9470 Main St
Whitmore Lake, MI 48189-9415
Phone (734) 449-9352
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016364 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298419200000",
"number": "1114125382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9470 MAIN ST",
"city": "WHITMORE LAKE",
"state": "MI",
"postal_code": "481899415",
"telephone_number": "734-449-9352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 ROBINDALE AVE",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481281012",
"telephone_number": "331-390-3469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMUDEZ",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2011-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "016364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.