Active NPI
Maxwell Berlin
- Health Maintenance Organization
- Boca Raton, FL
National Provider Identifier
1114775830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- LB-1563827
- Practice address
- 1301 Walnut Ter
Boca Raton, FL 33486-6909 - Phone
- (332) 373-4307
- NPI assigned
- May 8, 2024
- 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 |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | LB-1563827 | NY | Primary |
Addresses
Primary practice location
1301 Walnut Ter
Boca Raton, FL 33486-6909
Mailing address
1301 Walnut Ter
Boca Raton, FL 33486-6909
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 |
|---|---|---|---|
| LB-1563827 | NY | MD | Health Maintenance Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715126400000",
"number": "1114775830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 WALNUT TER",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334866909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 WALNUT TER",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334866909",
"telephone_number": "332-373-4307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLIN",
"first_name": "MAXWELL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-08",
"last_updated": "2024-05-08",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "NY",
"license": "LB-1563827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.