MEDICARE: DR. ANTHONY J BERNI M.D.

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	207X00000X	Orthopaedic Surgery Physician	103624	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	115065	OTHER	MO	BLUE CROSS BLUE SHIELD
2	SP17697	OTHER		CIGNA
3	384663	OTHER		HEALTHLINK
4	30186V3458	OTHER		GHP/ADVANTRA
5	901011	OTHER		UHC
6	9221	OTHER		EXCLUSIVE CHOICE
7	6091V6097	OTHER		HEALTHCARE USA

General Provider Information

NPI Number	:	1710980875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY J BERNI M.D.

Provider Business Mailing Address
First Line	:	9323 PHOENIX VILLAGE PKWY
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63368-4281
Country	:	US
Telephone Number	:	636-561-0871
Fax Number	:

Provider Business Practice Location Address
First Line	:	9323 PHOENIX VILLAGE PKWY
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63368-4281
Country	:	US
Telephone Number	:	636-561-0871
Fax Number	:

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/17/2023

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