Edsell Carlos Bernardo, M.D.
Individual provider Active NPI Internal Medicine Physician · Westerly, RI
NPI 1962664706 · NPPES record last updated Dec 15, 2021
Key facts
- NPI
- 1962664706
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 12727 (RI)
- Practice address
- 46 Wells St
Westerly, RI 02891-2924 - Phone
- (401) 596-0174
- Fax
- (401) 596-2266
- NPI assigned
- Jul 1, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000
710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000
7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000
901 Nevin Ave
Richmond, CA 94801-3143
Phone (510) 307-1500
Hospital & facility affiliations
- Kaiser Foundation Hospital - Fremont
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131226000483 | CA | Practitioner - Internal Medicine | 4880752567 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12727 | RI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Internal Medicine | Current |
Accepting new patients |
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| L&M Physician Association, Inc | Internal Medicine | Past | Accepting new patients |
Locations
39400 Paseo Padre Pkwy
Fremont, CA 94538
Phone (510) 248-3000
1800 Harrison St
Fl 7
Oakland, CA 94612
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 12727 | RI | Yes |
Addresses
Primary practice location
46 Wells St
Westerly, RI 02891-2924
Mailing address
46 Wells St
Westerly, RI 02891-2924
Phone (401) 596-0174
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3V4135 | Other | HEALTH NET | |
| EB75465 | Medicaid | RI | |
| 010012727RI01 | Other | RI | ANTHEM |
| 53205 | Other | CT | CONNECTICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Westerly, RI
- Beachcrest Dental, Inc.
- John Carmen Beauchamp
- Brett Steven Beaulieu
- Gary Benedetti
- Christopher Benn
- BHG Lvi, LLC
- BHG Lvii, LLC
- BHG Lxxix, LLC
- Russell N. Bingham
- Colette Bissonnette
All providers in Westerly, RI · Internal Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.