Individual provider Active NPI

Eleanore Clare Bernadas, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1306137500
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A119875 Issued in CA
Practice address
200 W Arbor Dr
#8829
San Diego, CA 92103-9001
Phone
(619) 543-7768
NPI assigned
Apr 22, 2011
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 65465 AZ
Internal Medicine Physician 207R00000X C1-0024725 DE
Internal Medicine Physician 207R00000X 90731 GA
Internal Medicine Physician 207R00000X 036.158154 IL
Internal Medicine Physician 207R00000X D92993 MD
Internal Medicine Physician 207R00000X 21734 NV
Internal Medicine Physician 207R00000X MD174045 OR
Internal Medicine Physician 207R00000X 64865 TN
Internal Medicine Physician 207R00000X T5718 TX
Internal Medicine Physician 207R00000X A119875 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
#8829
San Diego, CA 92103-9001

Mailing address

200 W Arbor Dr
San Diego, CA 92103-9000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20151216001173 OR Practitioner - Internal Medicine 8628379609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

300 N Graham St
Suite 200
Portland, OR 97227-1676

650 5TH St
Suite 405
San Francisco, CA 94107-1541

815 NE Davis St
Portland, OR 97232-1964

815 NE Davis St
Portland, OR 97232-2964

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65465AZMDInternal Medicine Physician
A119875CAMDInternal Medicine Physician
C1-0024725DEMDInternal Medicine Physician
90731GAMDInternal Medicine Physician
036.158154ILMDInternal Medicine Physician
D92993MDMDInternal Medicine Physician
21734NVMDInternal Medicine Physician
64865TNMDInternal Medicine Physician
T5718TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Jan 11, 2016 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jan 11, 2016 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Samg Inc Past Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

300 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4134

500 N Columbia River Hwy
Ste 6
Saint Helens, OR 97051
Phone (503) 366-5101

Interoperability endpoints

  • Direct secure messaging: ebernadas127737@direct.lhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1306137500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "#8829",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-543-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNADAS",
        "first_name": "ELEANORE",
        "middle_name": "CLARE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "65465",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0024725",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "90731",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.158154",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D92993",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "21734",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD174045",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "64865",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T5718",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A119875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.