Individual provider Active NPI

Tori Berry, PA

  • Medical Physician Assistant
  • Dayton, OH
National Provider Identifier
1033944103
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.008945RX Issued in OH
Practice address
1989 Miamisburg Centerville Rd
Dayton, OH 45459-3859
Phone
(937) 429-0607
Fax
(937) 702-9041
NPI assigned
Sep 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.008945RX OH Primary

Addresses

Primary practice location

1989 Miamisburg Centerville Rd
Dayton, OH 45459-3859

Mailing address

2633 Commons Blvd Ste 120
Beavercreek, OH 45431-3827
Phone (937) 429-0607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251226001800 OH Practitioner - Physician Assistant 7719473974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suresh Gupta MD IncGroup PAC ID 3173426350, 8 clinicians

Practice addresses (Care Compare)

1010 Woodman Dr
Dayton, OH 45432-1400
Phone (937) 252-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.008945RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suresh Gupta MD Inc CurrentSince Dec 15, 2025 Accepting new patients

Locations

1010 Woodman Dr
Dayton, OH 45432
Phone (937) 252-5500

7774 Dayton Springfield Rd
Fairborn, OH 45324
Phone (937) 864-2369

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1033944103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 COMMONS BLVD STE 120",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313827",
            "telephone_number": "937-429-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 MIAMISBURG CENTERVILLE RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593859",
            "telephone_number": "937-429-0607",
            "fax_number": "937-702-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "TORI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.008945RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.