NPIMap

Individual provider Active NPI

Marina V Berndt, MD

  • Family Medicine Physician
  • Olympia, WA
National Provider Identifier
1346290244
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60243905 Issued in WA
Practice address
525 Lilly Rd NE Ste 250
PMG SW Wa East Olympia Fam Med
Olympia, WA 98506-5101
Phone
(360) 486-6777
Fax
(360) 486-6778
NPI assigned
May 11, 2006
Last updated
Apr 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60243905 WA Primary

Addresses

Primary practice location

525 Lilly Rd NE Ste 250
PMG SW Wa East Olympia Fam Med
Olympia, WA 98506-5101

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983

Other practice location 1

1620 Cooper Point Rd SW
Olympia, WA 98502-5736
Phone (360) 486-6710

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mberndt92749@wm.providencedirect.org Direct
Direct Messaging Address mberndt92749@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20121105000591 WA Practitioner - Family Practice 5698785699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1450 Northwest LN SE
Suite a
Lacey, WA 98503-6908
Phone (360) 491-4460

525 Lilly Rd NE
Olympia, WA 98506-5101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60243905WAMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mberndt92749@wm.providencedirect.org

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1346290244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE STE 250",
            "address_2": "PMG SW WA EAST OLYMPIA FAM MED",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-486-6777",
            "fax_number": "360-486-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Cooper Point Rd SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985025736",
            "country_code": "US",
            "telephone_number": "360-486-6710",
            "fax_number": "360-705-0614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNDT",
        "first_name": "MARINA",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60243905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mberndt92749@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1620 Cooper Point Rd SW",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985025736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mberndt92749@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "525 Lilly Rd NE Ste 250",
            "address_2": "PMG SW WA East Olympia Fam Med",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.