Individual provider Active NPI

Christopher G Bermudez, PA-C

  • Physician Assistant
  • Yuma, AZ
National Provider Identifier
1144690140
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6066 Issued in AZ
Practice address
11142 S Scottsdale Dr
Yuma, AZ 85367-5616
Phone
(928) 539-0055
Fax
(928) 539-0053
NPI assigned
Oct 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X AZ 6066 AZ
Physician Assistant 363A00000X 6066 AZ Primary

Addresses

Primary practice location

11142 S Scottsdale Dr
Yuma, AZ 85367-5616

Mailing address

2400 S Avenue a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151215002860 AZ Practitioner - Physician Assistant 2365743416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

11142 S Scottsdale Dr
Yuma, AZ 85367-5616
Phone (928) 336-1815

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Hospital & facility affiliations

  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6066AZMDOccupational Therapist
AZ 6066AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Jan 20, 2019 Accepting new patients

Locations

1394 W 16th St
Yuma, AZ 85364
Phone (928) 539-0055

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

11142 S Scottsdale Dr
Yuma, AZ 85367
Phone (928) 336-1815

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1144690140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "928-344-2000",
            "fax_number": "928-539-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11142 S SCOTTSDALE DR",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853675616",
            "telephone_number": "928-539-0055",
            "fax_number": "928-539-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-02",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "AZ 6066",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.