Active NPI
Rosaleah Victorino Bernardo, MD
- Pediatrics Physician
- Saint Cloud, MN
National Provider Identifier
1225084445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 36065
- Practice address
- 1406 6TH Ave N
Saint Cloud, MN 56303-1900 - Phone
- (320) 251-2700
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4117 | SD | |
| Pediatrics Physician | 208000000X | 36065 | MN | Primary |
Addresses
Primary practice location
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Mailing address
7008 Maple LN
Horace, ND 58047-4713
Phone (701) 282-3929
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4117 | SD | MD | Pharmacist |
| 36065 | MN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220486400000",
"number": "1225084445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7008 MAPLE LN",
"city": "HORACE",
"state": "ND",
"postal_code": "580474713",
"telephone_number": "701-282-3929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031900",
"telephone_number": "320-251-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNARDO",
"first_name": "ROSALEAH",
"middle_name": "VICTORINO",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2008-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SD",
"license": "4117",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "36065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.