Ida M. Bernstein, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Providence, RI
NPI 1760912463 · NPPES record last updated Jul 1, 2024
Key facts
- NPI
- 1760912463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD20021 (RI)
- Practice address
- 1 Randall SQ
Providence, RI 02904-2709 - Phone
- (401) 274-6339
- Fax
- (401) 453-6290
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Harvard Medical School, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Providence Community Health Centers Inc.
Practice addresses (Care Compare)
1 Randall SQ
Providence, RI 02904-2709
Phone (401) 274-6339
375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220112002700 | MA | Practitioner - Obstetrics/Gynecology | 4284044280 | |
| I20240715002277 | RI | Practitioner - Obstetrics/Gynecology | 4284044280 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290604 | MA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Community Health Centers, Inc | Current |
Accepting new patients | |
| The Providence Community Health Centers Inc. | Past | Accepting new patients |
Locations
1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500
375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 290604 | MA | |
| Obstetrics & Gynecology Physician | 207V00000X | MD20021 | RI | Yes |
Addresses
Primary practice location
1 Randall SQ
Providence, RI 02904-2709
Mailing address
375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110179616A | Medicaid | MA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Other providers in Providence, RI
- Nadia M Bernier
- Taylor Bernier
- Ellis M Berns
- Scott David Berns
- Emily Bernstein
- Marcy Ellen Bernstein
- Virginia Bernstein
- Erika Berrio
- Jesus Berrio
- Julio Berroa
All providers in Providence, RI · Obstetrics & Gynecology Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.