Individual provider Active NPI

Ida M. Bernstein, MD

  • Obstetrics & Gynecology Physician
  • Providence, RI
National Provider Identifier
1760912463
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD20021 Issued in RI
Practice address
1 Randall SQ
Providence, RI 02904-2709
Phone
(401) 274-6339
Fax
(401) 453-6290
NPI assigned
Jun 14, 2017
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 290604 MA
Obstetrics & Gynecology Physician 207V00000X MD20021 RI Primary

Addresses

Primary practice location

1 Randall SQ
Providence, RI 02904-2709

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220112002700 MA Practitioner - Obstetrics/Gynecology 4284044280
I20240715002277 RI Practitioner - Obstetrics/Gynecology 4284044280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Harvard Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20021RIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Community Health Centers, Inc CurrentSince Jul 8, 2024 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1760912463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042709",
            "telephone_number": "401-274-6339",
            "fax_number": "401-453-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "IDA",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "290604",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "MD20021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "33 Kendall St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.