Individual provider Active NPI

Marc A Bernhisel, M.D.

  • Reproductive Endocrinology Physician
  • Tampa, FL
National Provider Identifier
1528053667
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
ME47242 Issued in FL
Practice address
5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126
Phone
(813) 914-7304
Fax
(813) 676-8838
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X ME47242 FL Primary
Reproductive Endocrinology Physician 207VE0102X 165085-1205 UT
Reproductive Endocrinology Physician 207VE0102X 27121 NC

Addresses

Primary practice location

5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126

Mailing address

5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126
Phone (813) 914-7304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27121NCMDReproductive Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1528053667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 E FLETCHER AVE",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171126",
            "telephone_number": "813-914-7304",
            "fax_number": "813-676-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 E FLETCHER AVE",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171126",
            "telephone_number": "813-914-7304",
            "fax_number": "813-676-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNHISEL",
        "first_name": "MARC",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "FL",
            "license": "ME47242",
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "UT",
            "license": "165085-1205",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NC",
            "license": "27121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.