Individual provider Active NPI

Katie Bernardoni, MD

  • Obstetrics & Gynecology Physician
  • Canton, MI
National Provider Identifier
1457514465
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301092696 Issued in MI
Practice address
49650 Cherry Hill Rd Ste 220
Canton, MI 48187-4860
Phone
(734) 398-7888
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301092696 MI Primary

Addresses

Primary practice location

49650 Cherry Hill Rd Ste 220
Canton, MI 48187-4860

Mailing address

49650 Cherry Hill Rd Ste 220
Canton, MI 48187-4860

Other names 1

  • Katie Reed Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120817000226 MI Practitioner - Obstetrics/Gynecology 2264688605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

49650 Cherry Hill Rd
Suite 220
Canton, MI 48187-4860
Phone (734) 398-7888

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation Obstetrics & Gynecology CurrentSince Jul 1, 2012 Accepting new patients
Iha Health Services Corporation Obstetrics & Gynecology CurrentSince Jul 1, 2012 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients
Iha Health Services Corporation Past Accepting new patients
Iha Health Services Corporation Obstetrics & Gynecology Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

7575 Grand River Rd
Ste 208
Brighton, MI 48114
Phone (810) 844-7740

49650 Cherry Hill Rd
Ste 220
Canton, MI 48187
Phone (734) 398-7888

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

990 W Ann Arbor Trl
Ste 302
Plymouth, MI 48170
Phone (734) 414-1090

4990 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 572-7500

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

5333 McAuley Dr
Rm 2110
Ypsilanti, MI 48197
Phone (734) 712-3967

Interoperability endpoints

  • Direct secure messaging: kbernardoni37053@direct.trinity-health.org

Organizations & group practices 5

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

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1457514465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49650 CHERRY HILL RD STE 220",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49650 CHERRY HILL RD STE 220",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874860",
            "telephone_number": "734-398-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDONI",
        "first_name": "KATIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301092696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "REED",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.