Active NPI
Jake Berkowitz
- Athletic Trainer
- Panorama City, CA
National Provider Identifier
1013417047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 13967 Roscoe Blvd
Panorama City, CA 91402-4245 - Phone
- (818) 849-6417
- NPI assigned
- Feb 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | CA | Primary |
Addresses
Primary practice location
13967 Roscoe Blvd
Panorama City, CA 91402-4245
Mailing address
12244 Burbank Blvd Apt 108
Valley Village, CA 91607-5103
Other practice location 1
12244 Burbank Blvd #108
Valley Village, CA 91607
Phone (818) 634-1860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2255A2300X | Other | ATHLETIC TRAINER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1013417047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12244 BURBANK BLVD APT 108",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916075103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13967 ROSCOE BLVD",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "914024245",
"telephone_number": "818-849-6417"
}
],
"practiceLocations": [
{
"address_1": "12244 Burbank Blvd #108",
"address_purpose": "LOCATION",
"city": "Valley Village",
"state": "CA",
"postal_code": "91607",
"country_code": "US",
"telephone_number": "818-634-1860",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERKOWITZ",
"first_name": "JAKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-02-16",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "2255A2300X",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Panorama City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.