Individual provider Active NPI

Pearl J Bader, M.D.

  • Psychiatry Physician
  • Richmond, VA
National Provider Identifier
1720179534
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101046919 Issued in VA
Practice address
107 S 5TH St
Richmond, VA 23219-3825
Phone
(804) 819-4000
Fax
(804) 819-4268
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101046919 VA Primary

Addresses

Primary practice location

107 S 5TH St
Richmond, VA 23219-3825

Mailing address

107 S 5TH St
Richmond, VA 23219-3825
Phone (804) 819-4000

Other identifiers 1

IdentifierTypeStateIssuer
010141052MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060320000669 VA Practitioner - Psychiatry 8123035912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albert Einstein College of Medicine of Yeshiva University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richmond Behavioral Health AuthorityGroup PAC ID 7810896370, 13 clinicians

Practice addresses (Care Compare)

107 S 5TH St
Richmond, VA 23219-3825
Phone (804) 819-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101046919VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Behavioral Health Authority CurrentSince Aug 1, 2010 Accepting new patients

Locations

107 S 5th St
Richmond, VA 23219
Phone (804) 819-4000

Organizations & group practices 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1720179534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "PEARL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101046919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010141052",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.