Marinette Gonzales Bernardo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A96571 Issued in CA

Practice address

1721 E Hammer LN Ste a
Stockton, CA 95210-4124

Phone

(209) 373-2829

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mbernardo768011@direct.ochin.org
• Direct secure messaging: marinette.bernardo.p1@direct.cmcentersinc.nextgenshare.com

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.

• Community Medical Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Esparto, CA
  • NPI 1588729180
  Medicare reassignment NPD
• Community Medical Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Stockton, CA
  • NPI 1356723936
  NPD
• Community Medical Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Lodi, CA
  • NPI 1891529061
  NPD
• Community Medical Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Stockton, CA
  • NPI 1538223375
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1154426179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952010779",
            "telephone_number": "209-373-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E HAMMER LN STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952104124",
            "telephone_number": "209-373-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDO",
        "first_name": "MARINETTE",
        "middle_name": "GONZALES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A96571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A965710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bermudez
• Christine Bernabe
• Pamela Bernal
• Allison Britney Igtanloc Bernardo, DO
• Mara Da Luz Bernardo, RDN, CSO
• Joseph William Bernstein
• Devonna Berry
• Michaela Berry
• Jackie Berryessa
• Mark Paul Beseda, PHARMACIST

• Internal Medicine Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.