MEDICARE: MR. ANTHONY ROBERT BERNUI PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA450	TN
2	363AS0400X	Surgical Physician Assistant	PA450	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4060688	OTHER	TN	BCBS
2	4060688	OTHER	TN	TENNCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1027331	OTHER		NCCPA CERTIFICATION #
5	1106613	OTHER	TN	VHP

General Provider Information

NPI Number	:	1952397994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY ROBERT BERNUI PA-C

Provider Business Mailing Address
First Line	:	1310 24TH AVE S
Second Line	:	SURGICAL SERVICE
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2637
Country	:	US
Telephone Number	:	615-873-7235
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 24TH AVE S
Second Line	:	SURGICAL SERVICE
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2637
Country	:	US
Telephone Number	:	615-873-7235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	01/12/2024

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