Individual provider Active NPI

John W Berry, MD

  • Emergency Medicine Physician
  • Wynnewood, PA
National Provider Identifier
1154394591
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD421083 Issued in PA
Practice address
100 West Lancaster Avenue
Wynnewood, PA 19096
Phone
(610) 645-2420
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD421083 PA Primary

Addresses

Primary practice location

100 West Lancaster Avenue
Wynnewood, PA 19096

Mailing address

PO Box 3012
Wilmington, DE 19804
Phone (800) 456-4629

Other identifiers 1

IdentifierTypeStateIssuer
0019577500002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040513001370 PA Practitioner - Emergency Medicine 0042200826 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD421083PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Emergency Med Associates LLC Emergency Medicine CurrentSince Jul 1, 2003 Accepting new patients

Locations

56 W Main St
Ste 305
Christiana, DE 19702

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

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.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154394591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3012",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19804",
            "telephone_number": "800-456-4629",
            "fax_number": "302-224-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WEST LANCASTER AVENUE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "19096",
            "telephone_number": "610-645-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD421083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019577500002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.