NPIMap

Organization Active NPI

Beverly Radiology Medical Group

Doing business as Vanowen Advanced Imaging

  • Diagnostic Radiology Physician
  • Van Nuys, CA
National Provider Identifier
1164760823
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
FNP 43686 Issued in CA
Legal business name
BEVERLY RADIOLOGY MEDICAL GROUP
Doing business as
Vanowen Advanced Imaging
Practice address
15243 Vanowen St
Van Nuys, CA 91405-3605
Phone
(818) 782-6110
Fax
(818) 782-7354
NPI assigned
Jan 30, 2013
Last updated
Jan 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Authorized official

Name
Howard G. Berger, M.D.
Title
Ceo & President
Phone
(310) 445-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X FNP 43686 CA Primary

Addresses

Primary practice location

15243 Vanowen St
Van Nuys, CA 91405-3605

Mailing address

15243 Vanowen St
Van Nuys, CA 91405-3605
Phone (818) 782-6110

Other names 1

  • Vanowen Advanced Imaging Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031106000784 CA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 343 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20040202001145 CA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 330 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1164760823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-782-6110",
            "fax_number": "818-782-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-782-6110",
            "fax_number": "818-782-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY RADIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO & PRESIDENT",
        "authorized_official_telephone_number": "310-445-2800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "FNP 43686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vanowen Advanced Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.