Individual provider Active NPI

Andrew E Berkow, M.D.

  • Diagnostic Radiology Physician
  • Davenport, IA
National Provider Identifier
1174584528
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
21211 Issued in IA
Practice address
1970 E 53Rd St
Davenport, IA 52807-2710
Phone
(563) 359-3949
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 21211 IA Primary

Addresses

Primary practice location

1970 E 53Rd St
Davenport, IA 52807-2710

Mailing address

1970 E 53Rd St
Davenport, IA 52807-2710
Phone (563) 359-3949

Other identifiers 11

IdentifierTypeStateIssuer
6176404MedicaidIA
17640OtherBCBS OF IOWA WITH RGIC LL
20790OtherIABCBS OF IOWA W/ ORA
300132305OtherRAILROAD MEDICARE RGIC LL
1176404MedicaidIA
20790OtherIAMEDICARE W/ ORA
3176404OtherIAMEDICAID W/ ORA
300016598OtherRAILROAD MEDICARE RG PC
30010OtherBCBS OF IOWA / WITH RG PC
300125723OtherIARAILROAD MEDICARE W/ ORA
K51232OtherIAMEDICARE - ORA ILLINOIS

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
21211IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Past Accepting new patients
Ora Orthopedics PC Past Accepting new patients
Radiology Group Imaging Center, L.L.C. Diagnostic Radiology Past Accepting new patients
Genesis Health System Past Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Organizations & group practices 5

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1174584528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072710",
            "telephone_number": "563-359-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072710",
            "telephone_number": "563-359-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOW",
        "first_name": "ANDREW",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "21211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6176404",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA WITH RGIC LL",
            "identifier": "17640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA W/ ORA",
            "identifier": "20790",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE RGIC LL",
            "identifier": "300132305",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1176404",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE W/ ORA",
            "identifier": "20790",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID W/ ORA",
            "identifier": "3176404",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE RG PC",
            "identifier": "300016598",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA / WITH RG PC",
            "identifier": "30010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE W/ ORA",
            "identifier": "300125723",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - ORA ILLINOIS",
            "identifier": "K51232",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.