Individual provider Active NPI

Elias Berro Jr., PA-C

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1194489443
Registry record updated Oct 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062179 Issued in PA
Practice address
2024 E Cedar St
Allentown, PA 18109-8154
Phone
(610) 969-8873
NPI assigned
Oct 23, 2021
Last updated
Oct 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA062179 PA Primary

Addresses

Primary practice location

2024 E Cedar St
Allentown, PA 18109-8154

Mailing address

2024 E Cedar St
Allentown, PA 18109-8154
Phone (610) 969-8873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA062179PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Project Vida Health Center Past Accepting new patients

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, 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": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634947200000",
    "number": "1194489443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 E CEDAR ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181098154",
            "telephone_number": "610-969-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 E CEDAR ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181098154",
            "telephone_number": "610-969-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRO",
        "first_name": "ELIAS",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-23",
        "last_updated": "2021-10-23",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.