NPIMap

Individual provider Active NPI

Ovidio Bernabe Bermudez, MD

  • Pediatric Adolescent Medicine Physician
  • Denver, CO
National Provider Identifier
1598724445
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
49298 Issued in CO
Practice address
8140 E 5TH Avenue
Eating Recovery Center
Denver, CO 80230-6492
Phone
(918) 671-7393
Fax
(303) 364-1812
NPI assigned
Mar 20, 2006
Last updated
May 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 49298 CO Primary

Addresses

Primary practice location

8140 E 5TH Avenue
Eating Recovery Center
Denver, CO 80230-6492

Mailing address

8140 E 5TH Avenue
Eating Recovery Center
Denver, CO 80230-6492
Phone (918) 671-7393

Other identifiers 3

IdentifierTypeStateIssuer
200055420AMedicaidOK
2238093OtherCIGNA BEHAVIORAL HEALTH
4220021OtherAETNA BEHAVIORAL HEALTH

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
49298COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pathlight Neuropsychiatric Center LLC Past Accepting new patients
Eating Recovery Center, LLC Past Accepting new patients
Pathlight Neuropsychiatric Center LLC Past Accepting new patients

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1598724445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 E 5TH AVENUE",
            "address_2": "EATING RECOVERY CENTER",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802306492",
            "telephone_number": "918-671-7393",
            "fax_number": "303-364-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 E 5TH AVENUE",
            "address_2": "EATING RECOVERY CENTER",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802306492",
            "telephone_number": "918-671-7393",
            "fax_number": "303-364-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "OVIDIO",
        "middle_name": "BERNABE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CO",
            "license": "49298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200055420A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2238093",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "4220021",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.