Eleanore Clare Bernadas, M.D.
Individual provider Active NPI Internal Medicine Physician · San Diego, CA
NPI 1306137500 · NPPES record last updated May 7, 2024
Key facts
- NPI
- 1306137500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A119875 (CA)
- Practice address
- 200 W Arbor Dr
#8829
San Diego, CA 92103-9001 - Phone
- (619) 543-7768
- NPI assigned
- Apr 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151216001173 | OR | Practitioner - Internal Medicine | 8628379609 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65465 | AZ | MD | Internal Medicine Physician |
| A119875 | CA | MD | Internal Medicine Physician |
| C1-0024725 | DE | MD | Internal Medicine Physician |
| 90731 | GA | MD | Internal Medicine Physician |
| 036.158154 | IL | MD | Internal Medicine Physician |
| D92993 | MD | MD | Internal Medicine Physician |
| 21734 | NV | MD | Internal Medicine Physician |
| MD174045 | OR | MD | Internal Medicine Physician |
| 64865 | TN | MD | Internal Medicine Physician |
| T5718 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current |
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
- ebernadas127737@direct.lhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 | Yes |
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
Other providers in San Diego, CA
- Carmelita Bermundo
- Bethani Ann Bernaba
- Bob Naim Bernaba
- Narae Lee Bernabe
- Prima Bernabe Bernabe
- Alex Bernadett
- Bernadette B. Heid, Psy.D., a Professional Psychology Corporation
- Luis Andre Bernal Hernandez
- Pixan Bernal-Villalpando
- Andrea Bernal
All providers in San Diego, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.