NPIMap

Individual provider Active NPI

Leonides D. Bermejo, MD

  • Neurology Physician
  • Hot Springs, AR
National Provider Identifier
1821319989
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
E-8640 Issued in AR
Practice address
1 Mercy LN Ste 505
Hot Springs, AR 71913-6462
Phone
(501) 623-2426
Fax
(501) 623-2405
NPI assigned
Jun 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 27735 OK
Neurology Physician 2084N0400X E-8640 AR Primary

Addresses

Primary practice location

1 Mercy LN Ste 505
Hot Springs, AR 71913-6462

Mailing address

PO Box 21850
Hot Springs, AR 71903-1850
Phone (501) 623-2426

Other identifiers 1

IdentifierTypeStateIssuer
204513001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140903001328 AR Practitioner - Neurology 8729206826 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27735OKMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI St. Vincent Medical Group Hot Springs CurrentSince Oct 1, 2014 Accepting new patients

Locations

1 Mercy Ln
Ste 505
Hot Springs, AR 71913
Phone (501) 623-0280

1 Mercy Ln
Ste 301
Hot Springs, AR 71913
Phone (501) 622-6556

1 Mercy Ln
Ste 401
Hot Springs National Park, AR 71913
Phone (501) 623-5220

1 Mercy Ln
Ste 201
Hot Springs National Park, AR 71913
Phone (501) 321-2229

Interoperability endpoints

  • Direct secure messaging: lbermejo165523@directb.mercy.net

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.

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI St Vincent Medical Group Hot Springs 184 clinicians

Practice addresses (Care Compare)

1 Mercy LN
Suite 401
Hot Springs National Park, AR 71913-6441
Phone (501) 623-5220

Hospital & facility affiliations

  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1821319989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21850",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719031850",
            "telephone_number": "501-623-2426",
            "fax_number": "501-623-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCY LN STE 505",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136462",
            "telephone_number": "501-623-2426",
            "fax_number": "501-623-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMEJO",
        "first_name": "LEONIDES",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "27735",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AR",
            "license": "E-8640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204513001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

Verify at the official NPI Registry.