Jonathan Mark Bernheimer, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2021027522 Issued in MO

Practice address

1 Childrens PL
Div Ped Academics, Ste 2D
Saint Louis, MO 63110-1002

Phone

(314) 454-6300

Fax

(833) 969-0131

NPI assigned

Jul 12, 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbernheimer628031@direct.ochin.org

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.

• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1780195255
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1609925957
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1245255207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "MSC 8515-87-1200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6300",
            "fax_number": "833-969-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PED ACADEMICS, STE 2D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6300",
            "fax_number": "833-969-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNHEIMER",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2021027522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200099068",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Academics, Ste 2D",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher D Berner, P.A.-C
• Cynthia Berner, MS, RD, LD
• Kimberly A. Bernert, M.A., CCC-SLP
• Bradley Bernhard, M.D.
• Noah Bernhardson, MD
• Anthony Paul Bernick, MD
• Aimee M Bernier
• Paul Michael Bernier, O.D.
• Matthew Berning, LAT, ATC
• Julie Tiedeman Berninger, PNP

• Pediatrics Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.