Shannon Bernbaum

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12100 Issued in TX

Practice address

18400 Katy Fwy Ste 530
Houston, TX 77094-1376

Phone

(281) 717-4003

NPI assigned

Jun 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: shannon.bernbaum.1@15397.direct.athenahealth.com

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.

• Houston Female Urology PA

  dba ChristiMD Medical Group

  • Medical Specialty Clinic/Center
  • Houston, TX
  • NPI 1255750063
  Medicare reassignment
• Lifesculpt Urogynecology PLLC

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Houston, TX
  • NPI 1316827165
  NPD (past)

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1891280988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18400 KATY FWY",
            "address_2": "STE 530",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941376",
            "telephone_number": "281-717-4003",
            "fax_number": "281-206-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18400 KATY FWY STE 530",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941376",
            "telephone_number": "281-717-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNBAUM",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernardo Treistman MD PLLC
• Bethany Bernardo, NP-C
• Marializa V Bernardo, M.D., P.A.
• Alyssa Bernas
• Michael Bernascone
• Donna K Berner, PA
• Sonya Bernhardt
• Theresa C Berniard, CRNA
• Jessica Delaisse Bernica, M.D.
• Marilise Anne Berniger, PA-C

• Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.