Individual provider Active NPI

Brian William Bernish, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1679134464
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09217 Issued in NC
Practice address
1665 Westbrook Plaza Dr
Winston Salem, NC 27103-2993
Phone
(336) 760-8380
NPI assigned
Jun 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-09217 NC Primary

Addresses

Primary practice location

1665 Westbrook Plaza Dr
Winston Salem, NC 27103-2993

Mailing address

7085 Bridgewood Rd
Clemmons, NC 27012-9097
Phone (336) 409-0314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190805001156 NC Practitioner - Physician Assistant 4385971050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

791 Jonestown Rd
WFBH Psychiatry Jonestown
Winston-Salem, NC 27103-1252
Phone (336) 716-2255

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0010-09217NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Care, LLC CurrentSince Aug 12, 2019 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Aug 12, 2019 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jun 6, 2021 Accepting new patients

Locations

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

200 Charlois Blvd
Ste 250
Winston Salem, NC 27103
Phone (336) 716-4649

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

791 Jonestown Rd
Winston Salem, NC 27103

1665 Westbrook Plaza Dr
Winston Salem, NC 27103
Phone (336) 760-8380

Interoperability endpoints

  • Direct secure messaging: bbernish2755296@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1679134464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7085 BRIDGEWOOD RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129097",
            "telephone_number": "336-409-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 WESTBROOK PLAZA DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032993",
            "telephone_number": "336-760-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNISH",
        "first_name": "BRIAN",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.