Individual provider Active NPI

Barry Kerner, MD

  • Psychiatry Physician
  • Fairfield, CT
National Provider Identifier
1205059417
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036885 Issued in CT
Practice address
52 Beach Rd
Suite 104
Fairfield, CT 06824-6017
Phone
(203) 254-2000
Fax
(203) 255-3126
NPI assigned
Apr 10, 2007
Last updated
Aug 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036885 CT Primary

Addresses

Primary practice location

52 Beach Rd
Suite 104
Fairfield, CT 06824-6017

Mailing address

52 Beach Rd
Suite 104
Fairfield, CT 06824-6017
Phone (203) 254-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20120524000416 CT Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 7719146554 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

1635 Central Ave
Bridgeport, CT 06610-2717
Phone (203) 551-7464

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036885CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc Psychiatry CurrentSince Sep 8, 2020 Accepting new patients
State of Connecticut CurrentSince Feb 7, 2023 Accepting new patients
Cyril Waynik MD PC Psychiatry CurrentSince Jun 1, 2014 Accepting new patients
Optimus Health Care Inc CurrentSince May 1, 2020 Accepting new patients
State of Connecticut CurrentSince Feb 7, 2023 Accepting new patients

Locations

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

52 Beach Rd
Ste 104
Fairfield, CT 06824
Phone (203) 254-2000

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1205059417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BEACH RD",
            "address_2": "SUITE 104",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246017",
            "telephone_number": "203-254-2000",
            "fax_number": "203-255-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BEACH RD",
            "address_2": "SUITE 104",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246017",
            "telephone_number": "203-254-2000",
            "fax_number": "203-255-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER",
        "first_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "036885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.