Provider Demographics
NPI:1568643120
Name:BERNARDINI, DONALD JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JONATHAN
Last Name:BERNARDINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80001-0668
Mailing Address - Country:US
Mailing Address - Phone:303-750-8100
Mailing Address - Fax:
Practice Address - Street 1:10700 E GEDDES AVE STE 100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3861
Practice Address - Country:US
Practice Address - Phone:303-750-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7857207L00000X, 207LP2900X, 208VP0014X
VA0101248997207LP2900X
CO53756207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BX065OtherBCBS ID
CO361349YPYZMedicare PIN
TX8BX065OtherBCBS ID