Keith Berndtson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36-067274 Issued in IL

Practice address

15 N Prospect Ave
Park Ridge, IL 60068-3563

Phone

(847) 232-9800

Fax

(847) 232-8910

NPI assigned

Nov 22, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2014 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1417/brand/1/csg/1/fhir/r4

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.

• Whole Health Affiliates S.C.

  • Chiropractor
  • Glenview, IL
  • NPI 1972611978
  NPD (past) Authorized official
• Illinois Multi-Med SC

  • Specialist
  • Glenview, IL
  • NPI 1851465587
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1235204397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N PROSPECT AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683785",
            "telephone_number": "847-232-9800",
            "fax_number": "847-232-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N PROSPECT AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683563",
            "telephone_number": "847-232-9800",
            "fax_number": "847-232-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNDTSON",
        "first_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36-067274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip J Berent, M.D.
• Gayle F Bereskin, DO
• Margaret Ann Berger, LCSW
• Christopher J Bergin, MD
• Luz B Bernal
• Bruce S Bernheim, MD
• Avi Bernstein, M.D.
• Susan Mary Bertucci-Maratea, M.A., CCC-SLP
• Peter R Bessette, MD
• Beth C Caron

• Family Medicine Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.