Organization Active NPI

Raleigh Pediatric Associates, PA

  • Pediatrics Physician
  • Raleigh, NC
National Provider Identifier
1508941535
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
RALEIGH PEDIATRIC ASSOCIATES, PA
Practice address
1921 Falls Valley Dr
Raleigh, NC 27615-3446
Phone
(919) 872-0250
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Jerry C. Bernstein, M.D.
Title
Physician Owner
Phone
(919) 872-0250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1921 Falls Valley Dr
Raleigh, NC 27615-3446

Mailing address

1921 Falls Valley Dr
Raleigh, NC 27615-3446
Phone (919) 872-0250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131009001204 NC Part B Supplier - Clinic/Group Practice 5991939837 Receives reassigned benefits from 8 practitioners
Practice locations: Garner, NC; Raleigh, NC

National Provider Directory

National Provider Directory

Locations

1405 Timber Dr E
Garner, NC 27529
Phone (919) 779-6423

1921 Falls Valley Dr
Raleigh, NC 27615
Phone (919) 872-0250

Practitioners & affiliated clinicians

Practitioners 12

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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508941535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 FALLS VALLEY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153446",
            "telephone_number": "919-872-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 FALLS VALLEY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153446",
            "telephone_number": "919-872-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH PEDIATRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "919-872-0250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.