Individual provider Active NPI

Ellis R. Berkowitz, M.D.02

  • Internal Medicine Physician
  • Saint Joseph, MO
National Provider Identifier
1124058425
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R8874 Issued in MO
Practice address
5514 Corporate Dr Ste 120
Saint Joseph, MO 64507-7754
Phone
(816) 271-1350
Fax
(816) 271-1355
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R8874 MO Primary

Addresses

Primary practice location

5514 Corporate Dr Ste 120
Saint Joseph, MO 64507-7754

Mailing address

5514 Corporate Dr Ste 120
Saint Joseph, MO 64507-7754
Phone (816) 271-1350

Other identifiers 3

IdentifierTypeStateIssuer
110045416OtherMORR MEDICARE
100312810AMedicaidKS
209319003MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000752 MO Practitioner - Internal Medicine 7214958883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Washington University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability KCGroup PAC ID 0143116368, 166 clinicians
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

3011 Baltimore Ave
Kansas City, MO 64108-3403
Phone (816) 751-7832

5202 Faraon St
Suite a
Saint Joseph, MO 64506-3840
Phone (816) 271-1067

5301 Faraon St
Saint Joseph, MO 64506-3512
Phone (816) 271-7546

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-3500

5514 Corporate Dr
Suite 150
Saint Joseph, MO 64507-7763
Phone (816) 271-1220

901 Heartland Rd
Saint Joseph, MO 64506-6201

Hospital & facility affiliations

  • Mosaic Life Care Home Health Home health agency, Saint Joseph, MO, CCN 267064
  • Centerwell Home Health Home health agency, Overland Park, KS, CCN 177179
  • Freudenthal Home Health Home health agency, Saint Joseph, MO, CCN 267644
  • Mosaic Life Care Hospice Hospice, Saint Joseph, MO, CCN 261507
  • Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8874MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center CurrentSince Oct 1, 2005 Accepting new patients
Heartland Regional Medical Center Internal Medicine CurrentSince Oct 1, 2005 Accepting new patients
Heartland Regional Medical Center Internal Medicine Current Accepting new patients
Midwestern Health Management, Inc. Past Accepting new patients
Heartland Regional Medical Center Past Accepting new patients

Locations

3715 Beck Rd
Ste F
Saint Joseph, MO 64506
Phone (816) 271-4935

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1213

5514 Corporate Dr
Ste 120
Saint Joseph, MO 64507
Phone (816) 271-1350

5301 Faraon St
Ste 120
Saint Joseph, MO 64506
Phone (816) 271-6406

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

Interoperability endpoints

  • Direct secure messaging: ellis.berkowitz@direct.mymlc.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1124058425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5514 CORPORATE DR STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645077754",
            "telephone_number": "816-271-1350",
            "fax_number": "816-271-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5514 CORPORATE DR STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645077754",
            "telephone_number": "816-271-1350",
            "fax_number": "816-271-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOWITZ",
        "first_name": "ELLIS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.02",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R8874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110045416",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100312810A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209319003",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.