NPIMap

Organization Active NPI

Beverly Radiology Medical Group

  • Diagnostic Radiology Physician
  • Camarillo, CA
National Provider Identifier
1124072707
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BEVERLY RADIOLOGY MEDICAL GROUP
Practice address
3901 Las Posas Rd
Suite 104
Camarillo, CA 93010-1501
Phone
(805) 389-9657
Fax
(805) 389-3218
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Howard G Berger, MD
Title
President
Phone
(310) 445-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3901 Las Posas Rd
Suite 104
Camarillo, CA 93010-1501

Mailing address

PO Box 240086
Los Angeles, CA 90024-9186
Phone (310) 445-2800

Other identifiers 2

IdentifierTypeStateIssuer
GR0081050MedicaidCA
ZZZ55194ZOtherCABLUE SHIELD

Other names 1

  • Camarillo Imaging Center Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beverly Radiology Medic III14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

3801 Las Posas Rd
Ste 214
Camarillo, CA 93010
Phone (805) 437-0900

3901 Las Posas Rd
Ste 104
Camarillo, CA 93010
Phone (805) 389-9657

Practitioners & affiliated clinicians

Practitioners 5

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124072707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240086",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900249186",
            "telephone_number": "310-445-2800",
            "fax_number": "310-445-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LAS POSAS RD",
            "address_2": "SUITE 104",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101501",
            "telephone_number": "805-389-9657",
            "fax_number": "805-389-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY RADIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-445-2800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0081050",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ55194Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camarillo Imaging Center Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.