Individual provider Active NPI

Larelisa Marie Ramos Bernardo, PT

  • Physical Therapist
  • Egg Harbor City, NJ
National Provider Identifier
1912067679
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00887300 Issued in NJ
Practice address
714 W. White Horse Pike
Suite B
Egg Harbor City, NJ 08215
Phone
(609) 965-9552
Fax
(609) 965-9553
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00887300 NJ Primary

Addresses

Primary practice location

714 W. White Horse Pike
Suite B
Egg Harbor City, NJ 08215

Mailing address

452 E. Exeter Court
Galloway, NJ 08205
Phone (609) 965-9552

Other identifiers 1

IdentifierTypeStateIssuer
2342238000OtherNJAMERIHEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240314001019 NJ Practitioner - Physical Therapist in Private Practice 9537114384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00887300NJMDPhysical Therapist
019153NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ambassadors Health Care LLC Physical Therapist CurrentSince Feb 20, 2024 Accepting new patients
Hands-on Plus Spine & Orthopedic Physical Therapy Physical Therapist Current Accepting new patients

Locations

714 W White Horse Pike
#B
Egg Harbor City, NJ 08215
Phone (609) 404-9477

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912067679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 E. EXETER COURT",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "08205",
            "telephone_number": "609-965-9552",
            "fax_number": "609-965-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W. WHITE HORSE PIKE",
            "address_2": "SUITE B",
            "city": "EGG HARBOR CITY",
            "state": "NJ",
            "postal_code": "08215",
            "telephone_number": "609-965-9552",
            "fax_number": "609-965-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDO",
        "first_name": "LARELISA MARIE",
        "middle_name": "RAMOS",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00887300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2342238000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.