Active NPI
Berkeley Fial, PA
- Physician Assistant
- Boulder, CO
National Provider Identifier
1124513981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 6557
- Practice address
- 3575 Broadway St
Boulder, CO 80304-1825 - Phone
- (303) 449-0933
- NPI assigned
- Jun 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 6557 | CO | Primary |
| Physician Assistant | 363A00000X | 55696 | CA |
Addresses
Primary practice location
3575 Broadway St
Boulder, CO 80304-1825
Mailing address
9635 Avocet LN
Lafayette, CO 80026-9737
Phone (720) 308-1031
Other practice location 1
3400 Calloway Dr Ste 200
Bakersfield, CA 93312-2513
Phone (661) 410-7546
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3575 Broadway St
Boulder, CO 80304-1825
Phone (303) 449-0933
400 S McCaslin Blvd
100 Boulder Dermatology
Louisville, CO 80027-9701
Phone (303) 666-5261
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.17 of 100
- Quality
- 88.33
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55696 | CA | MD | Pharmacist |
| 6557 | CO | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Dermatology Physician
- Boulder, CO
- NPI 1790145183
Hospital & facility affiliations 34
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1124513981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9635 AVOCET LN",
"city": "LAFAYETTE",
"state": "CO",
"postal_code": "800269737",
"telephone_number": "720-308-1031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3575 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041825",
"telephone_number": "303-449-0933"
}
],
"practiceLocations": [
{
"address_1": "3400 Calloway Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Bakersfield",
"state": "CA",
"postal_code": "933122513",
"country_code": "US",
"telephone_number": "661-410-7546",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FIAL",
"first_name": "BERKELEY",
"name_prefix": "Miss",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-25",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "6557",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "55696",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.