Individual provider Active NPI

Karim E Berty, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Andover, MA
National Provider Identifier
1174843114
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN-21685 Issued in MA
Practice address
15 Central St
Andover, MA 01810-3718
Phone
(978) 470-0330
NPI assigned
Jun 1, 2010
Last updated
Jun 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN-21685 MA Primary

Addresses

Primary practice location

15 Central St
Andover, MA 01810-3718

Mailing address

15 Central St
Andover, MA 01810-3718
Phone (978) 470-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 15, 2025 through May 15, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DN-21685MAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Oral & Maxillofacial Surgery Associates, P.C. Oral and Maxillofacial Surgery 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1174843114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CENTRAL ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103718",
            "telephone_number": "978-470-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CENTRAL ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103718",
            "telephone_number": "978-470-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTY",
        "first_name": "KARIM",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN-21685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.