Donald Lee Bernovich II, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5949 Issued in MN

Practice address

1101 E 78TH St
Suite 100
Bloomington, MN 55420-1400

Phone

(952) 854-5034

Fax

(952) 854-5363

NPI assigned

Dec 1, 2008

Last updated

Apr 4, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• Family Support Services Inc.

  dba Sagent Behavioral Health

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1225283492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E 78TH ST",
            "address_2": "SUITE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201400",
            "telephone_number": "952-854-5034",
            "fax_number": "952-854-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNOVICH",
        "first_name": "DONALD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Bergstrom
• Meron Berhane
• Zahra Berka
• Diamond Renea Berkley
• Jessica L Bernier, MSW, LICSW
• Paul Albert Berry, MD
• Carley Jeanne Berthiaume, PA-C
• Brooke Marie Bertram, MSW, LICSW
• Emmi J Berube
• Dean Benjamin Berzins, PA-C

• Clinical Psychologist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.