Individual provider Active NPI

Bernard Paul White, MD

  • Surgery Physician
  • Bronx, NY
National Provider Identifier
1720160971
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
159523 Issued in NY
Practice address
1610 Williamsbridge Rd Apt 1
Bronx, NY 10461-6289
Phone
(646) 533-5200
Fax
(646) 809-8597
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME141426 FL
Surgical Critical Care Physician 2086S0102X ME141426 FL
Surgical Critical Care Physician 2086S0102X 159523 NY
Surgery Physician 208600000X 159523 NY Primary

Addresses

Primary practice location

1610 Williamsbridge Rd Apt 1
Bronx, NY 10461-6289

Mailing address

1610 Williamsbridge Rd Apt 1
Bronx, NY 10461-6289
Phone (646) 533-5200

Other practice location 1

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-4225

Other identifiers 3

IdentifierTypeStateIssuer
01202079MedicaidNY
PENDINGOtherFLMEDICARE
PENDINGMedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040611000310 NY Practitioner - General SurgeryPractitioner - Other (Physician) 9133102965 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159523NYMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Westchester Hospital Association CurrentSince Jun 27, 2011 Accepting new patients
Northern Westchester Hospital Association Current Accepting new patients
Northern Westchester Hospital Association CurrentSince Jun 27, 2011 Accepting new patients
Park Avenue Surgical Associates, P.C. Surgery Past Accepting new patients

Locations

480 Bedford Rd
Chappaqua, NY 10514
Phone (866) 997-5781

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

Interoperability endpoints

  • Direct secure messaging: bwhite389428@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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1720160971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 WILLIAMSBRIDGE RD APT 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104616289",
            "telephone_number": "646-533-5200",
            "fax_number": "646-809-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 WILLIAMSBRIDGE RD APT 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104616289",
            "telephone_number": "646-533-5200",
            "fax_number": "646-809-8597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "32901",
            "country_code": "US",
            "telephone_number": "321-434-4225",
            "fax_number": "321-434-4247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BERNARD",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME141426",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME141426",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "159523",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "159523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01202079",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.