Individual provider Active NPI

R. Laurence Berkowitz, M.D.

  • Specialist
  • Campbell, CA
National Provider Identifier
1154417657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C36957 Issued in CA
Practice address
3803 S. Bascom Avenue #100
Campbell, CA 95008
Phone
(408) 559-7177
Fax
(408) 559-7199
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C36957 CA Primary

Addresses

Primary practice location

3803 S. Bascom Avenue #100
Campbell, CA 95008

Mailing address

3803 S. Bascom Avenue #100
Campbell, CA 95008
Phone (408) 559-7177

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 Medicine

State licenses

LicenseStateTypeSpecialty
C36957CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Arts Surgery Suite a Medical Corporation PastSince Apr 21, 2003 Accepting new patients

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154417657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 S. BASCOM AVENUE #100",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-559-7177",
            "fax_number": "408-559-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 S. BASCOM AVENUE #100",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-559-7177",
            "fax_number": "408-559-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOWITZ",
        "first_name": "R. LAURENCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C36957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.