Individual provider Active NPI

Bernard W Segall, D.M.D.,M.S.

  • Prosthodontics
  • Coconut Grove, FL
National Provider Identifier
1265560148
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN0005796 Issued in FL
Practice address
2601 S Bayshore Dr
Suite # 760
Coconut Grove, FL 33133-5417
Phone
(305) 857-0990
Fax
(305) 857-9180
NPI assigned
Mar 1, 2007
Last updated
May 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DN0005796 FL Primary

Addresses

Primary practice location

2601 S Bayshore Dr
Suite # 760
Coconut Grove, FL 33133-5417

Mailing address

2601 S Bayshore Dr
Suite # 760
Coconut Grove, FL 33133-5417
Phone (305) 857-0990

Other names 1

  • Bernard W Segall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120717000152 FL Practitioner - Oral Surgery 9032375290

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2601 S Bayshore Dr
Suite 760
Coconut Grove, FL 33133-5413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN0005796FLMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1265560148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 S BAYSHORE DR",
            "address_2": "SUITE # 760",
            "city": "COCONUT GROVE",
            "state": "FL",
            "postal_code": "331335417",
            "telephone_number": "305-857-0990",
            "fax_number": "305-857-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 S BAYSHORE DR",
            "address_2": "SUITE # 760",
            "city": "COCONUT GROVE",
            "state": "FL",
            "postal_code": "331335417",
            "telephone_number": "305-857-0990",
            "fax_number": "305-857-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGALL",
        "first_name": "BERNARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN0005796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNARD",
            "last_name": "SEGALL",
            "middle_name": "W",
            "credential": "M.D.,M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coconut Grove, FL

Sources for this page

Verify at the official NPI Registry.