Individual provider Active NPI

Jon E Bjornerud, M.D.

  • Anesthesiology Physician
  • Mangonia Park, FL
National Provider Identifier
1346390887
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME128156 Issued in FL
Practice address
901 45TH St
Mangonia Park, FL 33407-2413
Phone
(561) 844-6300
NPI assigned
Jan 10, 2007
Last updated
May 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00040825 WA
Anesthesiology Physician 207L00000X ME128156 FL Primary
Pediatric Anesthesiology Physician 207LP3000X MD00040825 WA

Addresses

Primary practice location

901 45TH St
Mangonia Park, FL 33407-2413

Mailing address

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161208001569 FL Practitioner - Anesthesiology 9739266214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Anesthesia and Pain Treatment PAGroup PAC ID 8426201401, 88 clinicians

Practice addresses (Care Compare)

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME128156FLMDAnesthesiology Physician
MD00040825WAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Anesthesia & Pain Treatment, P.a. Anesthesiology CurrentSince Oct 1, 2016 Accepting new patients
St Lukes Clinic - Wood River LLC Anesthesiology Past Accepting new patients

Locations

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313
Phone (866) 747-5834

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

Organizations & group practices 2

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 1

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1346390887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 45TH ST",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH ST",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORNERUD",
        "first_name": "JON",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00040825",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME128156",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "WA",
            "license": "MD00040825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mangonia Park, FL

Sources for this page

Verify at the official NPI Registry.