Individual provider Active NPI

Gabrielle Dionyse Lauren Bernard, MD

  • Emergency Medicine Physician
  • Renton, WA
National Provider Identifier
1275589608
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60862290 Issued in WA
Practice address
1205 N 10TH St Ste a
Renton, WA 98057-5577
Phone
(425) 690-3475
Fax
(425) 690-9475
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G85928 CA
Emergency Medicine Physician 207P00000X MD60862290 WA Primary

Addresses

Primary practice location

1205 N 10TH St Ste a
Renton, WA 98057-5577

Mailing address

3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057-4970
Phone (425) 690-2715

Other practice location 1

525 N Garfield Ave
Monterey Park, CA 91754-1202
Phone (626) 307-2129

Other identifiers 7

IdentifierTypeStateIssuer
00G859280OtherCABLUE SHIELD
050126CG35107OtherCAVALLEY PRES TRAILBLAZER
G85928OtherCABLUE CROSS
930123114OtherCAVALLEY PRES RAILROAD
2106688MedicaidWA
00G859280MedicaidCA
00G859280OtherCACALOPTIMA

Other names 1

  • Dr. Gabrielle Diony Lauren Bernard Professional name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ Other
Direct Messaging Address gbernard82233@direct.valleymed.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA, FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080611000533 TX Practitioner - Emergency Medicine 9133013436 Reassigns benefits to 1 organization
I20181026001416 WA Practitioner - Emergency Medicine 9133013436 Reassigns benefits to 4 organizations
I20220301001747 FL Practitioner - Emergency Medicine 9133013436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60862290WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Valley Medical Group-Renton CurrentSince Jan 1, 2020 Accepting new patients
Sound Physicians Emergency Medicine of Washington PLLC Emergency Medicine CurrentSince Oct 1, 2019 Accepting new patients
Prosser Public Hospital District of Benton County CurrentSince Jul 1, 2019 Accepting new patients
St Joseph Emergency Physicians PLLC Emergency Medicine CurrentSince Sep 20, 2014 Accepting new patients
Prosser Public Hospital District of Benton County CurrentSince Jul 1, 2019 Accepting new patients
Prosser Public Hospital District of Benton County Current Accepting new patients
St Joseph Emergency Physicians PLLC Emergency Medicine CurrentSince Sep 20, 2014 Accepting new patients
Inphynet South Broward LLC Emergency Medicine Past Accepting new patients
Glendale Emergency Medical Associates, Inc Emergency Medicine Past Accepting new patients
Garfield Emergency Medical Associates, Inc. Emergency Medicine Past Accepting new patients
DRH Medical Group Past Accepting new patients

Locations

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

1105 Dale Ave
Benton City, WA 99320
Phone (509) 588-4075

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

200 Prosser Health Dr
Prosser, WA 99350
Phone (509) 786-2222

1205 N 10th St
Ste A
Renton, WA 98057
Phone (425) 656-4211

3600 Lind Ave SW
Ste 100
Renton, WA 98057

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Interoperability endpoints

  • Direct secure messaging: gbernard82233@direct.valleymed.org
  • Direct secure messaging: gbernard422480@direct.peacehealth.org

Organizations & group practices 12

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1275589608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N 10TH ST STE A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575577",
            "telephone_number": "425-690-3475",
            "fax_number": "425-690-9475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 N Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "Monterey Park",
            "state": "CA",
            "postal_code": "917541202",
            "country_code": "US",
            "telephone_number": "626-307-2129",
            "fax_number": "626-307-2056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "GABRIELLE",
        "middle_name": "DIONYSE LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G85928",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60862290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G859280",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALLEY PRES TRAILBLAZER",
            "identifier": "050126CG35107",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G85928",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALLEY PRES RAILROAD",
            "identifier": "930123114",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2106688",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G859280",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "00G859280",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1205 N 10th St Ste A",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980575577",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbernard82233@direct.valleymed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "gbernard82233@direct.valleymed.org",
            "address_1": "1205 N 10th St Ste A",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980575577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "BERNARD",
            "middle_name": "DIONY LAUREN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.