Individual provider Active NPI

Maria Rita Bernardo, DDS

  • Dentist
  • Charleston, WV
National Provider Identifier
1215907290
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3285 Issued in WV
Practice address
116 Hills PLZ
Charleston, WV 25387-2438
Phone
(304) 414-4493
Fax
(304) 720-4813
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3285 WV Primary

Addresses

Primary practice location

116 Hills PLZ
Charleston, WV 25387-2438

Mailing address

301-6 Great Teays Blvd
Scott Depot, WV 25560
Phone (304) 757-6999

Other identifiers 3

IdentifierTypeStateIssuer
000970197OtherWVMS BCBS
0134436000MedicaidWV
5525660OtherWVAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418000174 WV Practitioner - Dentist 3375841851 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Womencare Inc Current Accepting new patients
Womencare, Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare, Inc CurrentSince Jan 1, 2016 Accepting new patients
Women Care Inc Dentist Past Accepting new patients

Locations

116 Hills Plz
Charleston, WV 25387
Phone (304) 720-4446

97 Great Teays Blvd
Ste 6
Scott Depot, WV 25560

12803 Winfield Rd
Winfield, WV 25213
Phone (304) 586-3088

Organizations & group practices 6

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1215907290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301-6 GREAT TEAYS BLVD",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "25560",
            "telephone_number": "304-757-6999",
            "fax_number": "304-757-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 HILLS PLZ",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872438",
            "telephone_number": "304-414-4493",
            "fax_number": "304-720-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDO",
        "first_name": "MARIA",
        "middle_name": "RITA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BCBS",
            "identifier": "000970197",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134436000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5525660",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.