Individual provider Active NPI

Ellen S Berne, MD

  • Internal Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1528033321
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD040062E Issued in PA
Practice address
120 Lytton Ave
Suite M059
Pittsburgh, PA 15213-1481
Phone
(412) 623-8905
Fax
(412) 623-8906
NPI assigned
Feb 23, 2006
Last updated
Jul 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD040062E PA Primary

Addresses

Primary practice location

120 Lytton Ave
Suite M059
Pittsburgh, PA 15213-1481

Mailing address

120 Lytton Ave
Suite M059
Pittsburgh, PA 15213-1481
Phone (412) 623-8905

Other identifiers 2

IdentifierTypeStateIssuer
0011722700012MedicaidPA
0011722700008MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20061204000526 PA Practitioner - Internal Medicine 2466451323 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD040062EPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc CurrentSince Feb 1, 2011 Accepting new patients
Upmc Community Medicine, Inc Internal Medicine Current Accepting new patients
Upmc Community Medicine Inc CurrentSince Feb 1, 2011 Accepting new patients

Locations

875 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 347-4622

120 Lytton Ave
Ste M59
Pittsburgh, PA 15213
Phone (412) 623-8905

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

5140 Liberty Ave
Pittsburgh, PA 15224
Phone (412) 682-2100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1528033321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LYTTON AVE",
            "address_2": "SUITE M059",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131481",
            "telephone_number": "412-623-8905",
            "fax_number": "412-623-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LYTTON AVE",
            "address_2": "SUITE M059",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131481",
            "telephone_number": "412-623-8905",
            "fax_number": "412-623-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNE",
        "first_name": "ELLEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD040062E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011722700012",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011722700008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.