Active NPI
Troy Berkley, HOME HEALTH AID
- Case Manager/Care Coordinator
- Phoenix, AZ
National Provider Identifier
1104483460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- AL10509H
- Practice address
- 18210 N 29TH St
Phoenix, AZ 85032-1103 - Phone
- (480) 302-1101
- Fax
- (480) 546-3131
- NPI assigned
- May 22, 2019
- Last updated
- Jun 11, 2019
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | AL10509H | AZ | Primary |
Addresses
Primary practice location
18210 N 29TH St
Phoenix, AZ 85032-1103
Mailing address
18210 N 29TH St
Phoenix, AZ 85032-1103
Phone (480) 302-1101
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL10509H | AZ | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miracle on 29TH Street | Case Manager/Care Coordinator | Past | 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": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1104483460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18210 N 29TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850321103",
"telephone_number": "480-302-1101",
"fax_number": "480-546-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18210 N 29TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850321103",
"telephone_number": "480-302-1101",
"fax_number": "480-546-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERKLEY",
"first_name": "TROY",
"credential": "HOME HEALTH AID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-22",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "AZ",
"license": "AL10509H",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.