Jack M Berdy, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA60816 Issued in NJ

Practice address

155 Cedar LN
Teaneck, NJ 07666-4301

Phone

(201) 836-4248

Fax

(201) 836-5420

NPI assigned

Apr 5, 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 9

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.

• Services of Physicians LLC

  • Internal Medicine Physician
  • East Orange, NJ
  • NPI 1336335264
  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1215999115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CEDAR LN",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664301",
            "telephone_number": "201-836-4248",
            "fax_number": "201-836-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CEDAR LN",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664301",
            "telephone_number": "201-836-4248",
            "fax_number": "201-836-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDY",
        "first_name": "JACK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA60816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH#",
            "identifier": "0853523000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "P00332714",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO#",
            "identifier": "0125870",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET#",
            "identifier": "3K3825",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO #",
            "identifier": "0479230",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS #",
            "identifier": "230SB2",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6925201",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD #",
            "identifier": "P3688668",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO#",
            "identifier": "0479230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce Bendavid, OTR
• Georgette Bennardo-Meggelin, D.D.S.
• Benoise M. Turnier, LCSW, LLC
• Madeline Bentley, CNA, CHHA
• Robert Berberian, M.D.
• Bergen Anesthesia Associates PA
• Bergen Cardiology Associates
• Bergen Infectious Diseases Associates Inc
• Bergen Medical Care LTD
• Bergen Perinatal Associates, LLC

• Internal Medicine Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.