Individual provider Active NPI

Brian W Berman, MD

  • Pediatric Hematology & Oncology Physician
  • Detroit, MI
National Provider Identifier
1043232523
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
4301101829 Issued in MI
Practice address
Children Hosp Michigan
3901 Beaubien St
Detroit, MI 48201
Phone
(216) 789-3470
Fax
(313) 966-6121
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 4301101829 MI Primary

Addresses

Primary practice location

Children Hosp Michigan
3901 Beaubien St
Detroit, MI 48201

Mailing address

680 Hanna St
Birmingham, MI 48009-1618
Phone (216) 789-3470

Other identifiers 2

IdentifierTypeStateIssuer
700F349850OtherMIBCBSM COMMON PIN
1043232523MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121003000550 MI Practitioner - Pediatric Medicine 8628968765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Temple University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University PediatriciansGroup PAC ID 9638070568, 121 clinicians

Practice addresses (Care Compare)

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301101829MIMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatric Hematology-Oncology CurrentSince Aug 5, 2020 Accepting new patients
University Pediatricians CurrentSince Aug 5, 2020 Accepting new patients
Childrens Research Foundation of Cleveland Pediatric Hematology-Oncology Past Accepting new patients

Locations

3901 Beaubien St
Fl 3
Detroit, MI 48201
Phone (313) 745-5906

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

Organizations & group practices 3

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1043232523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 HANNA ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091618",
            "telephone_number": "216-789-3470",
            "fax_number": "313-966-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDREN HOSP MICHIGAN",
            "address_2": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "216-789-3470",
            "fax_number": "313-966-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "BRIAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-02-04",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MI",
            "license": "4301101829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM COMMON PIN",
            "identifier": "700F349850",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043232523",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.