Individual provider Active NPI

Sufanna Bernarduci, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1255064051
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011498 Issued in NC
Practice address
5102 N Roxboro St
Durham, NC 27704-1420
Phone
(919) 620-4855
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW15044 FL
Clinical Social Worker 1041C0700X C011498 NC Primary

Addresses

Primary practice location

5102 N Roxboro St
Durham, NC 27704-1420

Mailing address

PO Box 110566
Durham, NC 27709-5566
Phone (919) 620-4855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20230127002417 NC Practitioner - Clinical Social Worker 6507237690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5102 N Roxboro St
Durham, NC 27704-1420
Phone (919) 471-1518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW15044FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. CurrentSince Mar 6, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. Current Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Mar 6, 2023 Accepting new patients

Locations

5102 N Roxboro St
Durham, NC 27704
Phone (919) 613-3115

4220 N Roxboro St
Durham, NC 27704
Phone (919) 471-1518

Organizations & group practices 3

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1255064051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110566",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277095566",
            "telephone_number": "919-620-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277041420",
            "telephone_number": "919-620-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDUCI",
        "first_name": "SUFANNA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15044",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.