Individual ProviderSer Bernard BungubungNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2020 Wellness Way Ste 300, Las Vegas, NV 89106-4145(702) 432-2233PECOS EnrollmentBased on the most recent information from CMS, provider Ser Bernard Bungubung is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1467223008Provider TypeIndividualFull NameBungubung, Ser BernardCredentialAPRNGenderMaleSole ProprietorNoEnumeration Date1/11/2024Last Updated4/6/2024Contact InformationPractice LocationPractice Address2020 Wellness Way Ste 300, Las Vegas, NV 89106-4145Phone(702) 432-2233Fax(702) 800-5456Mailing LocationMailing Address1930 Village Center Cir Ste 3-717, Las Vegas, NV 89134-6299Phone(702) 432-2233Fax(702) 800-5456Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense875418NevadaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicenseRN73425NevadaProvider IdentifiersIDDescriptionIssuerID250030173DescriptionMedicaidIssuerUnlistedNevadaID16117083DescriptionOtherIssuerCAQH IDNevada