Feridoun Beroukhim, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

18648 Issued in WI

Practice address

2424 S 90TH St
Ste 504
West Allis, WI 53227-2455

Phone

(414) 328-8670

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• West Side Neurology SC

  • Neurology Physician
  • West Allis, WI
  • NPI 1265685093
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184642670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST",
            "address_2": "STE 125",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272466",
            "telephone_number": "414-328-3809",
            "fax_number": "414-328-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "address_2": "STE 504",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEROUKHIM",
        "first_name": "FERIDOUN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "18648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30922300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Beltrame, DDS
• Kyle Jeffrey Bemis, PHARM. D.
• Jayme Ann Berggren, APSW
• Susan Margaret Bernard, LPN
• Meredith Stone Bernt, AUD
• Brianna Berti
• Janeen Bester, MA, SACIT
• Jane Betlej, P.T.
• Zaharra Beyah
• Ilya Beyder

• Pediatrics Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Pediatrics Physician in Wisconsin

• 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.