Wading River Medical Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WADING RIVER MEDICAL CARE PC

Practice address

5972 Route 25a
Wading River, NY 11792-2001

Phone

(631) 929-0304

NPI assigned

Jun 23, 2015

Last updated

Jul 7, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Bernard, MDNPI 1023098464

Title

MD

Phone

(631) 929-0304

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Bernard, M.D.

  • Internal Medicine Physician
  • Wading River, NY
  • NPI 1023098464
  Medicare reassignment NPD Authorized official
• Allison Keneski, RPA-C

  • Physician Assistant
  • Riverhead, NY
  • NPI 1104091024
  Medicare reassignment
• Steven G. Selter, M.D.

  • Family Medicine Physician
  • Port Jefferson, NY
  • NPI 1568504322
  NPD (past)

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1568844801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5972 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5972 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922001",
            "telephone_number": "631-929-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADING RIVER MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "BERNARD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "631-929-0304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Verni
• Corinne Brooke Vidulich, M.D.
• Kim Ann Vitacco, NP
• Wading River Complete Dental Care PC
• Wading River Fire District
• Wading River Pediatric Dentistry, PC
• Wading River Physical Therapy, PC
• Jeffrey Todd Wagner, PT, DPT
• Walgreen Co (Walgreens # 09498)
• Denise Joanne Weber, R.PH

• Internal Medicine Physician in Wading River, NY
• Providers in Wading River, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.