Theodore B. Berndt, M.D.

Individual provider Active NPI Cardiovascular Disease Physician · Reno, NV

NPI 1154348100 · NPPES record last updated Jul 25, 2017

Key facts

NPI
1154348100
Entity type
Individual (NPI type 1)
Primary specialty
Cardiovascular Disease Physician 207RC0000X
License
3191 (NV)
Practice address
1155 Mill St
Reno, NV 89502-1576
Phone
(775) 982-7878
Fax
(775) 982-4196
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nhi-1 Cardiovascular Disease Past Accepting new patients
Primary Care Plus Foundation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G22670 CA
Cardiovascular Disease Physician 207RC0000X 3191 NV Yes

Addresses

Primary practice location

1155 Mill St
Reno, NV 89502-1576

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Other identifiers

IdentifierTypeStateIssuer
CC2328OtherNVBLUE CROSS BLUE SHIELD
11050642OtherCAQH
XPY183369MedicaidCA
002016077MedicaidNV

Other providers in Reno, NV

All providers in Reno, NV · Cardiovascular Disease Physician in Nevada

Sources for this page

Verify at the official NPI Registry.