Fred Berman

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A-1214 Issued in NM

Practice address

720 Saint Michaels Dr
Santa Fe, NM 87505-7600

Phone

(505) 438-9402

NPI assigned

Aug 6, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1114274453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 PASEO DE LA CONQUISTADORA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875012341",
            "telephone_number": "505-795-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057600",
            "telephone_number": "505-438-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "FRED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-1214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ira Charles Berkowitz, M.D.
• Iris Berkowitz, RN
• Deborra Berlin, LCSW
• Lydia Berlin
• Steve Berlyn, LISW ACSW
• Jennifer Bermudez-Trujillo
• Rebecca Lynne Bermudez, LISW, RIMHC
• Veronica Bernal, BMS
• Bernard R. Gavron D.D.S., P.C.
• Sameul A Berne, OD, FCOVD

• Physical Therapy Assistant in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Physical Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.