Active NPI
Berkshire Manor Inc
- Intellectual Disabilities Intermediate Care Facility
- San Bruno, CA
National Provider Identifier
1073663274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- BERKSHIRE MANOR INC
- Practice address
- 2820 Berkshire Dr
San Bruno, CA 94066-1754 - Phone
- (650) 544-8999
- Fax
- (650) 347-8887
- NPI assigned
- Jan 11, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Julie G Albero
- Title
- Director
- Phone
- (650) 544-8999
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | CA | Primary |
Addresses
Primary practice location
2820 Berkshire Dr
San Bruno, CA 94066-1754
Mailing address
2820 Berkshire Dr
San Bruno, CA 94066-1754
Phone (650) 544-8999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55 G499 | Other | CA | MEDICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G499
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- BERKSHIRE MANOR, INC
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Oct 7, 2004
- Last certification
- Nov 7, 2024
- Beds
- 6
- Ownership / control type
- Other (specify)
- Facility address
- 2820 Berkshire Drive
San Bruno, CA 94066
National Provider Directory
National Provider Directory- Tax ID family
- Berkshire Manor Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual Disabilities Intermediate Care Facility
- Campbell, CA
- NPI 1972653178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1073663274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 BERKSHIRE DR",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940661754",
"telephone_number": "650-544-8999",
"fax_number": "650-347-8887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 BERKSHIRE DR",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940661754",
"telephone_number": "650-544-8999",
"fax_number": "650-347-8887"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BERKSHIRE MANOR INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-11",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ALBERO",
"authorized_official_first_name": "JULIE",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "650-544-8999",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "55 G499",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.