Organization Active NPI

James R Berenson, M.D., Inc

  • Specialist
  • West Hollywood, CA
National Provider Identifier
1104943083
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
JAMES R BERENSON, M.D., INC
Practice address
9201 W Sunset Blvd
Suite 310
West Hollywood, CA 90069-3701
Phone
(310) 623-1222
Fax
(310) 623-1122
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Authorized official

Name
Dr. James Richard Berenson, M.D.NPI 1124051560
Title
President and Ceo
Phone
(310) 623-1222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

9201 W Sunset Blvd
Suite 310
West Hollywood, CA 90069-3701

Mailing address

9201 W Sunset Blvd
Suite 310
West Hollywood, CA 90069-3701
Phone (310) 623-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720001513 CA Part B Supplier - Clinic/Group Practice 6406836683 Receives reassigned benefits from 2 practitioners
Practice locations: West Hollywood, CA

National Provider Directory

National Provider Directory

Locations

9201 W Sunset Blvd
Ste 310
West Hollywood, CA 90069
Phone (310) 623-1222

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1104943083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 W SUNSET BLVD",
            "address_2": "SUITE 310",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900693701",
            "telephone_number": "310-623-1222",
            "fax_number": "310-623-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W SUNSET BLVD",
            "address_2": "SUITE 310",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900693701",
            "telephone_number": "310-623-1222",
            "fax_number": "310-623-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R BERENSON, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "BERENSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "310-623-1222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.