NPIMap

Individual provider Active NPI

Jennifer Bacalla Bernard, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Lakewood, CO
National Provider Identifier
1275706285
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
336079056 Issued in IL
Practice address
11700 W 2ND PL Ste 210E
Lakewood, CO 80228-1704
Phone
(720) 321-8460
Fax
(720) 321-8461
NPI assigned
Apr 10, 2008
Last updated
Nov 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 336079056 IL Primary

Addresses

Primary practice location

11700 W 2ND PL Ste 210E
Lakewood, CO 80228-1704

Mailing address

1900 W Polk St Ste 816
Chicago, IL 60612-3723
Phone (312) 864-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000217 CO Practitioner - Endocrinology 6204980246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336079056ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2013 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2013 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Catholic Health Initiatives Colorado Endocrinology, Diabetes & Metabolism Past Accepting new patients
Sofia Garcia-Buder, M.D., S.C. Endocrinology, Diabetes & Metabolism Past Accepting new patients
Advocate North Side Health Network Past Accepting new patients

Locations

360 Peak One Dr
Ste 300
Frisco, CO 80443
Phone (720) 321-8460

11700 W 2nd Pl
Ste 210
Lakewood, CO 80228
Phone (720) 321-8080

11750 W 2nd Pl
Ste 365
Lakewood, CO 80228
Phone (720) 321-8280

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

220 W 2nd St
Goodland, KS 67735
Phone (785) 890-3625

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1275706285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST STE 816",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 W 2ND PL STE 210E",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281704",
            "telephone_number": "720-321-8460",
            "fax_number": "720-321-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "JENNIFER",
        "middle_name": "BACALLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "336079056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.