Individual provider Active NPI

Jose Alberto Berrios, M.D.

  • Otolaryngology Physician
  • Palm Harbor, FL
National Provider Identifier
1053377754
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME0052177 Issued in FL
Practice address
800 Tarpon Woods Blvd
Suite D
Palm Harbor, FL 34685-2011
Phone
(727) 942-4005
Fax
(727) 934-1773
NPI assigned
Apr 22, 2006
Last updated
Oct 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME0052177 FL Primary
Pediatric Otolaryngology Physician 207YP0228X ME0052177 FL

Addresses

Primary practice location

800 Tarpon Woods Blvd
Suite D
Palm Harbor, FL 34685-2011

Mailing address

800 Tarpon Woods Blvd
Suite D
Palm Harbor, FL 34685-2011
Phone (727) 942-4005

Other identifiers 9

IdentifierTypeStateIssuer
214676OtherAVMED
ZA5283OtherBLUE CROSS MASSACHUSETTS
0600062OtherGHI
209756OtherAMERIGROUP
040014067OtherRR MEDICARE
593341132OtherTAX ID
02978OtherWELLCARE
7A7011OtherEMPIRE BLUE CROSS NY
047382100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20081016000356 FL Practitioner - Otolaryngology 0244398451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Tarpon Woods Blvd
Suite D
Palm Harbor, FL 34685-2000
Phone (727) 942-4005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.61 of 100Reported as individual
Quality
85.83
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0052177FLMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulfcoast Ear Nose & Throat Associates PA Otolaryngology CurrentSince Oct 3, 2007 Accepting new patients
James W. Adkins, MD PA CurrentSince Jan 10, 2011 Accepting new patients
David W. Malka MD, PA PastSince Mar 1, 2001 Accepting new patients
Optum Care Services Company Past Accepting new patients

Locations

800 Tarpon Woods Blvd
Ste D
Palm Harbor, FL 34685
Phone (727) 785-8877

3007 Ridgeline Blvd
Ste A
Tarpon Springs, FL 34688
Phone (727) 787-6453

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1053377754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TARPON WOODS BLVD",
            "address_2": "SUITE D",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852011",
            "telephone_number": "727-942-4005",
            "fax_number": "727-934-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TARPON WOODS BLVD",
            "address_2": "SUITE D",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852011",
            "telephone_number": "727-942-4005",
            "fax_number": "727-934-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIOS",
        "first_name": "JOSE",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME0052177",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME0052177",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "214676",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MASSACHUSETTS",
            "identifier": "ZA5283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0600062",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "209756",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "040014067",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "593341132",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "02978",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS NY",
            "identifier": "7A7011",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047382100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.