Active NPI
Jerome Berman, M.D.
- Ophthalmology Physician
- Flushing, NY
National Provider Identifier
1063511665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 112385
- Practice address
- 188 04 Northern Blvd
Flushing, NY 11358-2811 - Phone
- (718) 445-1090
- NPI assigned
- Sep 21, 2006
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 112385 | NY | Primary |
Addresses
Primary practice location
188 04 Northern Blvd
Flushing, NY 11358-2811
Mailing address
188 04 Northern Blvd
Flushing, NY 11358-2811
Phone (718) 445-1090
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 441181102 | Other | NY | RAILROAD MEDICARE |
| 00203452 | Medicaid | NY | |
| 112385A48 | Other | NY | HEALTH FIRST |
| 0012626 | Other | NY | GHI |
| 0C1099 | Other | NY | HEALTH NET |
| 608064 | Other | NY | AETNA |
| DS526 | Other | NY | OXFORD |
| P61159096 | Other | NY | MULTIPLAN |
| 973471 | Other | NY | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287619200000",
"number": "1063511665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 04 NORTHERN BLVD",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113582811",
"telephone_number": "718-445-1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 04 NORTHERN BLVD",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113582811",
"telephone_number": "718-445-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMAN",
"first_name": "JEROME",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2010-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "112385",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "441181102",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00203452",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH FIRST",
"identifier": "112385A48",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0012626",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "0C1099",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "608064",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "DS526",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "P61159096",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "973471",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.