Individual provider Active NPI

Berjees Mukhtar, M.D

  • Professional Counselor
  • Middletown, DE
National Provider Identifier
1184816597
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C1-0010258 Issued in DE
Practice address
4 McCumber LN
Middletown, DE 19709-9366
Phone
(816) 225-0965
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X LNMT191093 PA
Professional Counselor 101YP2500X C1-0010258 DE Primary

Addresses

Primary practice location

4 McCumber LN
Middletown, DE 19709-9366

Mailing address

4 McCumber LN
Middletown, DE 19709-9366
Phone (816) 225-0965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130308000352 DE Practitioner - Psychiatry 3971758301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
People'S Place II, Inc.Group PAC ID 3173519436, 18 clinicians

Practice addresses (Care Compare)

1131 Airport Rd
Milford, DE 19963-6418
Phone (302) 422-8026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0010258DEMDProfessional Counselor
LNMT191093PAMDStudent in an Organized Health Care Education/Training Program

Organizations & group practices 1

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": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1184816597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MCCUMBER LN",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197099366",
            "telephone_number": "816-225-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MCCUMBER LN",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197099366",
            "telephone_number": "816-225-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHTAR",
        "first_name": "BERJEES",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "LNMT191093",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DE",
            "license": "C1-0010258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

Verify at the official NPI Registry.