Individual provider Active NPI

Mark P Berland, DO

  • Gynecology Physician
  • Aurora, CO
National Provider Identifier
1124089107
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
20912 Issued in CO
Practice address
1550 S Potomac St
Suite 135
Aurora, CO 80012-5455
Phone
(303) 369-1019
Fax
(303) 369-1062
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 20912 CO Primary

Addresses

Primary practice location

1550 S Potomac St
Suite 135
Aurora, CO 80012-5455

Mailing address

1550 S Potomac St
Suite 135
Aurora, CO 80012-5455
Phone (303) 369-1019

Other identifiers 1

IdentifierTypeStateIssuer
01209121MedicaidCO

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20912COMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1124089107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S POTOMAC ST",
            "address_2": "SUITE 135",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125455",
            "telephone_number": "303-369-1019",
            "fax_number": "303-369-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S POTOMAC ST",
            "address_2": "SUITE 135",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125455",
            "telephone_number": "303-369-1019",
            "fax_number": "303-369-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLAND",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CO",
            "license": "20912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01209121",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.