Organization Active NPI

Head and Neck Surgery Specialists, a Professional Corporation

  • Otolaryngology Physician
  • Chula Vista, CA
National Provider Identifier
1124545074
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
HEAD AND NECK SURGERY SPECIALISTS, A PROFESSIONAL CORPORATION
Practice address
321 E St
Chula Vista, CA 91910-2667
Phone
(619) 934-3260
Fax
(619) 934-3268
NPI assigned
Aug 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Brett J. Berman, M.D.NPI 1457446684
Title
President
Phone
(619) 934-3260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

321 E St
Chula Vista, CA 91910-2667

Mailing address

321 E St
Chula Vista, CA 91910-2667
Phone (619) 934-3260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180403001416 CA Part B Supplier - Clinic/Group Practice 1658647250 Receives reassigned benefits from 5 practitioners
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

Locations

321 E St
Chula Vista, CA 91910
Phone (619) 422-0404

Practitioners & affiliated clinicians

Practitioners 6

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": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124545074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102667",
            "telephone_number": "619-934-3260",
            "fax_number": "619-934-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102667",
            "telephone_number": "619-934-3260",
            "fax_number": "619-934-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAD AND NECK SURGERY SPECIALISTS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERMAN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-934-3260",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.