Individual provider Active NPI

Bernard Harris, MD

  • Anesthesiology Physician
  • Warren, OH
National Provider Identifier
1174511331
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35.089072 Issued in OH
Practice address
667 Eastland Ave SE
Warren, OH 44484
Phone
(330) 841-4100
Fax
(330) 286-5396
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35.089072 OH Primary

Addresses

Primary practice location

667 Eastland Ave SE
Warren, OH 44484

Mailing address

4135 Boardman Canfield Rd Ste 101
Canfield, OH 44406-9803
Phone (330) 286-5330

Other practice location 1

34th Street & Civic Center Blvd
Suite 9329
Philadelphia, PA 19104-4399
Phone (215) 590-1858

Other practice location 2

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3658

Other practice location 3

8401 Market St
Youngstown, OH 44512-6725
Phone (330) 729-2929

Other identifiers 2

IdentifierTypeStateIssuer
0056624MedicaidOH
H065300OtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120220000499 OH Practitioner - Anesthesiology 5890885545 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesiologists, LTD. Anesthesiology CurrentSince Nov 23, 2011 Accepting new patients
Bel-Park Anesthesia Associates, Inc. Anesthesiology CurrentSince Jan 15, 2019 Accepting new patients

Locations

4135 Boardman Canfield Rd
Ste 101
Canfield, OH 44406
Phone (330) 532-7215

930 Bethel Rd
Columbus, OH 43214
Phone (614) 451-0500

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

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.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1174511331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD STE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44484",
            "telephone_number": "330-841-4100",
            "fax_number": "330-286-5396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34th Street & Civic Center Blvd",
            "address_2": "Suite 9329",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044399",
            "country_code": "US",
            "telephone_number": "215-590-1858",
            "fax_number": "215-590-1415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1044 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041006",
            "country_code": "US",
            "telephone_number": "330-480-3658",
            "fax_number": "330-480-3439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8401 Market St",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445126725",
            "country_code": "US",
            "telephone_number": "330-729-2929",
            "fax_number": "330-286-5396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.089072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056624",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H065300",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.