Bernard Leroy Bennett, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C42114 Issued in CA

Practice address

661 W 1St St Ste G
Tustin, CA 92780-2939

Phone

(714) 665-9890

Fax

(714) 665-9891

NPI assigned

Feb 22, 2006

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

Meharry Medical College School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All for Health Health for All IncGroup PAC ID 5698734788, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: bernard.bennettmd.p1@direct.afh.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• All for Health Health for All Inc

  • Federally Qualified Health Center (FQHC)
  • Glendale, CA
  • NPI 1568567220
  Medicare reassignment Care Compare group NPD
• Families Together of Orange County

  • Clinic/Center
  • Tustin, CA
  • NPI 1194122457
  Medicare reassignment NPD
• Inpatient Consultants of California, Inc.

  • Hospitalist Physician
  • Berkely, CA
  • NPI 1831134253

  Internal Medicine

  Medicare reassignment NPD
• Independence Health PC

  • Internal Medicine Physician
  • Mission Viejo, CA
  • NPI 1669942751
  Medicare reassignment
• All for Health Health for All Inc

  • Federally Qualified Health Center (FQHC)
  • Laguna Niguel, CA
  • NPI 1154044931
  NPD
• Families Together of Orange County

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1861253080
  NPD
• All for Health Health for All Inc

  • Federally Qualified Health Center (FQHC)
  • Las Vegas, NV
  • NPI 1023799285
  NPD
• Physicians Eldercare PA

  • General Practice Physician
  • Durham, NC
  • NPI 1023083268
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1871568899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21034 Pacific Coast Hwy # 2",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926485335",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "fax_number": "510-525-8982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9918 Katella Ave Ste A-C",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046465",
            "country_code": "US",
            "telephone_number": "714-644-9494",
            "fax_number": "714-644-9894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11180 Warner Ave Ste 353",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087516",
            "country_code": "US",
            "telephone_number": "714-968-6789",
            "fax_number": "714-202-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BERNARD",
        "middle_name": "LEROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C42114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891028P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00651283",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1028P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DO0034",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00062870",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DA5493",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Signe M Belden, DDS
• Bella Milagros Inc
• Belong Psychotherapy Inc
• Joshua Bravo Beltran, DC
• Sarai Sanchez Benitez
• Brendan Bennett
• Rachel Benson, LCSW
• Judith Benvenuto, LMFT
• Sarah Eileen Benz
• Kelly Lynn Berardini, MHA, ATC

• Internal Medicine Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.