Individual provider Active NPI

Suzannah Deborah Berlyne, M.D.

  • Nephrology Physician
  • Brooklyn, NY
National Provider Identifier
1164599122
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
197128 Issued in NY
Practice address
125 Oceana Dr E
Apt 3H
Brooklyn, NY 11235-6691
Phone
(917) 532-7352
Fax
(917) 677-4812
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 197128 NY Primary

Addresses

Primary practice location

125 Oceana Dr E
Apt 3H
Brooklyn, NY 11235-6691

Mailing address

200 Riverside Blvd
Apt 20 D
New York, NY 10069-0901
Phone (212) 579-3838

Other identifiers 1

IdentifierTypeStateIssuer
02011549MedicaidNY

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
197128NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Touch Medical Care, P.C. PastSince Aug 13, 1996 Accepting new patients
East Shore Medical PC Past Accepting new patients

Organizations & group practices 2

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1164599122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RIVERSIDE BLVD",
            "address_2": "APT 20 D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100690901",
            "telephone_number": "212-579-3838",
            "fax_number": "212-579-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OCEANA DR E",
            "address_2": "APT 3H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356691",
            "telephone_number": "917-532-7352",
            "fax_number": "917-677-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLYNE",
        "first_name": "SUZANNAH",
        "middle_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "197128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02011549",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.