Individual provider Active NPI

Craig Eagan Berris, M.D.

  • Specialist
  • Sacramento, CA
National Provider Identifier
1073538104
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G32698 Issued in CA
Practice address
77 Scripps Dr
Suite 201
Sacramento, CA 95825-6209
Phone
(916) 929-6707
Fax
(916) 929-6897
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G32698 CA Primary

Addresses

Primary practice location

77 Scripps Dr
Suite 201
Sacramento, CA 95825-6209

Mailing address

77 Scripps Dr
Suite 201
Sacramento, CA 95825-6209
Phone (916) 929-6707

Other identifiers 2

IdentifierTypeStateIssuer
94269970OtherCATAX ID
00G326980MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070417000574 CA Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 7517062722 Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32698CAMDGeneral Practice Dentistry
G32698CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Craig E. Berris PastSince May 1, 2024 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073538104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SCRIPPS DR",
            "address_2": "SUITE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256209",
            "telephone_number": "916-929-6707",
            "fax_number": "916-929-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SCRIPPS DR",
            "address_2": "SUITE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256209",
            "telephone_number": "916-929-6707",
            "fax_number": "916-929-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIS",
        "first_name": "CRAIG",
        "middle_name": "EAGAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G32698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "94269970",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G326980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.