Rolando Manalo Beredo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

RB060312 Issued in MI

Practice address

426 N Jackson St
Jackson, MI 49201-1235

Phone

(517) 788-6336

Fax

(517) 788-9035

NPI assigned

Oct 19, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• R M Beredo M D P L L C

  • Specialist
  • Jackson, MI
  • NPI 1912213604
  Authorized official Same address or phone

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093704322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1414",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492041414",
            "telephone_number": "517-788-6336",
            "fax_number": "517-788-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011235",
            "telephone_number": "517-788-6336",
            "fax_number": "517-788-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREDO",
        "first_name": "ROLANDO",
        "middle_name": "MANALO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "RB060312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "1103863092",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4179560",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "420017",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C1796",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bentley & Bentley, P.C.
• Roberta Lee Bentley, LPN
• Payton L Benton, PA-C
• Jessica Benz, FNP-C
• Matthew Gregory Benz
• Haven Berger
• Kenneth G Berger, LLPC
• Kimberly Anne Berger, AUDIOLOGIST
• Brandon Berka
• Andrea Bernard, MSW

• Internal Medicine Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.