Gina Lee Berkley, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95030669 Issued in CA

Practice address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone

(650) 498-3333

NPI assigned

Jun 7, 2022

Last updated

Mar 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Gina Lee Cannon Former name

Medicare fee-for-service enrollment

Enrolled in MI, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FIABCD

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

• LPCH Medical Group Div of Lucile

  dba Lucile Salter Packard Children's Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  Medicare reassignment NPD
• Stanford Health Care

  dba Stanford Medical Center A Trade Name for Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Medicare reassignment NPD
• Cardiology Consultants of East Michigan PLLC

  • Cardiovascular Disease Physician
  • Flint, MI
  • NPI 1285670299
  Medicare reassignment NPD
• Stanford Health Care

  dba SHC Radiation Oncology

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758
  NPD
• Stanford Health Care

  dba Stanford Health Care Specialty Pharmacy

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1053040816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-498-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4664 Tiger Lily Trl",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483464982",
            "country_code": "US",
            "telephone_number": "248-909-7133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1031 Suncrest Dr",
            "address_purpose": "LOCATION",
            "city": "Lapeer",
            "state": "MI",
            "postal_code": "484461136",
            "country_code": "US",
            "telephone_number": "810-664-4870",
            "fax_number": "810-664-0921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERKLEY",
        "first_name": "GINA",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704341531",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "4704341531",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95030669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "CANNON",
            "middle_name": "LEE",
            "credential": "NP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyra Berg, MD
• Miles Berger, MD
• Victoria Berger, M.D.
• Colin Bergstrom
• Melissa Therese Berhow, MD
• Rachel Berkowitz, M.D.
• Jesse Berman, M.D.
• Thomas James Bernard, PA-C
• Roberto Jesus Bernardo, MD
• Charlene Lee Bernarte, PA-C

• Nurse Practitioner in Stanford, CA
• Providers in Stanford, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.