Active NPI
Raleigh Pediatric Associates, PA
- Pediatrics Physician
- Raleigh, NC
National Provider Identifier
1508941535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Pediatrics Physician
- Washington, NC
- NPI 1376981944
NC, Pediatrics
-
- Student in an Organized Health Care Education/Training Program
- Atlanta, GA
- NPI 1659947794
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": []
}
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- Raleigh Orthopaedic Pharmacy
- Raleigh OT LLC
- Raleigh Pathology Laboratory Associates PA
- Raleigh Plastic Surgery Center
- Raleigh Plastic Surgery Center Inc
- Raleigh Preventative Care, PA
- Raleigh Primary Care Medicine, PA
- Raleigh Psychiatric Associates PA
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.