Individual provider Active NPI

Bernadette Suzanne McKell, D.O.

  • Internal Medicine Physician
  • Half Moon Bay, CA
National Provider Identifier
1710185053
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A12893 Issued in CA
Practice address
80 Cabrillo Hwy N Ste I
Half Moon Bay, CA 94019-1666
Phone
(650) 276-0170
Fax
(650) 440-4887
NPI assigned
Jul 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A12893 CA Primary

Addresses

Primary practice location

80 Cabrillo Hwy N Ste I
Half Moon Bay, CA 94019-1666

Mailing address

80 Cabrillo Hwy N Ste I
Half Moon Bay, CA 94019-1666
Phone (650) 276-0170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131010000915 CA Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 0648455196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

80 Cabrillo Hwy N
Suite I
Half Moon Bay, CA 94019-1666
Phone (650) 276-0170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12893CAMDInternal Medicine Physician
12893CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
B Suzanne McKell DO Inc Internal Medicine CurrentSince Dec 17, 2018 Accepting new patients
Hartford Physician Services PC Internal Medicine Past Accepting new patients

Locations

80 Cabrillo Hwy N
Ste I
Half Moon Bay, CA 94019
Phone (650) 276-0170

248 Main St
Ste 110
Half Moon Bay, CA 94019
Phone (650) 276-0170

220 Standiford Ave
Ste F
Modesto, CA 95350
Phone (209) 589-1500

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1710185053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 CABRILLO HWY N STE I",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191666",
            "telephone_number": "650-276-0170",
            "fax_number": "650-440-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 CABRILLO HWY N STE I",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191666",
            "telephone_number": "650-276-0170",
            "fax_number": "650-440-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELL",
        "first_name": "BERNADETTE",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-09",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A12893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Half Moon Bay, CA

Sources for this page

Verify at the official NPI Registry.