NPIMap

Organization Active NPI

Kevin Bernstein MD LLC

  • Geriatric Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1619213998
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
9507 Issued in NV
Legal business name
KEVIN BERNSTEIN MD LLC
Practice address
391 Fynn Valley Dr
Las Vegas, NV 89148-4454
Phone
(702) 405-9080
NPI assigned
Dec 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Kevin Bernstein, MDNPI 1609823533
Title
Owner
Phone
(702) 813-8079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0805X 9507 NV Primary

Addresses

Primary practice location

391 Fynn Valley Dr
Las Vegas, NV 89148-4454

Mailing address

391 Fynn Valley Dr
Las Vegas, NV 89148-4454
Phone (702) 506-3139

Other practice location 1

2031 McDaniel St Ste 170
North Las Vegas, NV 89030-6325
Phone (702) 506-3139

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Henderson

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130109000230 NV Part B Supplier - Clinic/Group Practice 7911150644 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1619213998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 FYNN VALLEY DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484454",
            "telephone_number": "702-506-3139",
            "fax_number": "702-259-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 FYNN VALLEY DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484454",
            "telephone_number": "702-405-9080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2031 McDaniel St Ste 170",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890306325",
            "country_code": "US",
            "telephone_number": "702-506-3139",
            "fax_number": "702-259-0205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEVIN BERNSTEIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-813-8079",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NV",
            "license": "9507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Henderson",
            "affiliation": "N",
            "address_1": "2900 W Horizon Ridge Pkwy Ste 100",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890525014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.

Verify at the official NPI Registry.