Individual provider Active NPI

Bente H Berman, M.D.

  • Dermatology Physician
  • Agoura Hills, CA
National Provider Identifier
1205913910
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G57381 Issued in CA
Practice address
29525 Canwood St
Suite 219
Agoura Hills, CA 91301-4233
Phone
(818) 865-8133
Fax
(818) 865-1223
NPI assigned
Nov 1, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G57381 CA Primary

Addresses

Primary practice location

29525 Canwood St
Suite 219
Agoura Hills, CA 91301-4233

Mailing address

29525 Canwood St
Suite 219
Agoura Hills, CA 91301-4233
Phone (818) 865-8133

Other identifiers 2

IdentifierTypeStateIssuer
G57381OtherCALICENSE #
95-4397431OtherCATAX ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120119000706 CA Practitioner - Dermatology 4587831326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Geffen School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29525 Canwood St
Suite 219
Agoura Hills, CA 91301-4231
Phone (818) 865-8133

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision33
Removal of skin lesions1165
Removal or shaving of skin growth134
Skin biopsy166

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G57381CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bente Berman MD Inc Dermatology CurrentSince Oct 6, 2011 Accepting new patients
Kpi Inc Past Accepting new patients
Robert Stephen Dye, M.D. Apc PastSince Oct 6, 2011 Accepting new patients
Debra G Tennen, MD, a Professional Medical Corporation Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

29525 Canwood St
Ste 219
Agoura Hills, CA 91301
Phone (818) 865-8133

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, 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205913910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST",
            "address_2": "SUITE 219",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014233",
            "telephone_number": "818-865-8133",
            "fax_number": "818-865-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST",
            "address_2": "SUITE 219",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014233",
            "telephone_number": "818-865-8133",
            "fax_number": "818-865-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "BENTE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G57381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "G57381",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "95-4397431",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

Verify at the official NPI Registry.