NPIMap

Organization Active NPI

Michael P Bernstein MD LLC

  • Otolaryngology Physician
  • Enfield, CT
National Provider Identifier
1508265646
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
027001 Issued in CT
Legal business name
MICHAEL P BERNSTEIN MD LLC
Practice address
146 Hazard Ave
Suite 204
Enfield, CT 06082-4571
Phone
(860) 763-3243
Fax
(860) 763-3244
NPI assigned
Aug 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Dr. Michael P Bernstein, M.D.NPI 1689668741
Title
Owner
Phone
(860) 763-3243

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X 027001 CT Primary
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X 000406 CT
Speech/Language/Hearing Specialist/TechnologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235500000X 000406 CT
Audiologist-Hearing Aid FitterGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 237600000X 000406 CT
Hearing Instrument SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 237700000X 000406 CT
Durable Medical Equipment & Medical Supplies 332B00000X 000406 CT
Hearing Aid Equipment 332S00000X 000406 CT

Addresses

Primary practice location

146 Hazard Ave
Suite 204
Enfield, CT 06082-4571

Mailing address

146 Hazard Ave
Suite 204
Enfield, CT 06082-4571
Phone (860) 763-3243

Other identifiers 1

IdentifierTypeStateIssuer
001270016MedicaidCT

Other names 1

  • MICHAEL BERNSTEIN SOLE MBR Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 18477871578 Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140820000014 CT Part B Supplier - Clinic/Group Practice 0648498444 Receives reassigned benefits from 4 practitioners
Practice locations: Enfield, CT

National Provider Directory

National Provider Directory

Locations

146 Hazard Ave
Ste 204
Enfield, CT 06082
Phone (860) 763-3243

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1508265646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 HAZARD AVE",
            "address_2": "SUITE 204",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824571",
            "telephone_number": "860-763-3243",
            "fax_number": "860-763-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 HAZARD AVE",
            "address_2": "SUITE 204",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824571",
            "telephone_number": "860-763-3243",
            "fax_number": "860-763-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL P BERNSTEIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-763-3243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CT",
            "license": "027001",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000406",
            "primary": false
        },
        {
            "code": "235500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist",
            "state": "CT",
            "license": "000406",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CT",
            "license": "000406",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hearing Instrument Specialist",
            "state": "CT",
            "license": "000406",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "000406",
            "primary": false
        },
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "CT",
            "license": "000406",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001270016",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "18477871578",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "146 Hazard Ave Ste 204",
            "city": "Enfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060824566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MICHAEL BERNSTEIN SOLE MBR",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MICHAEL BERNSTEIN SOLE MBR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.