Michael James Berardis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X-005871-1 Issued in NY

Practice address

3671 Old Yorktown Rd
Shrub Oak, NY 10588-1503

Phone

(914) 962-1234

Fax

(914) 962-1312

NPI assigned

Jun 22, 2005

Last updated

Sep 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Berardis Family Chiropractic, PC

  • Chiropractor
  • Shrub Oak, NY
  • NPI 1972747954
  Medicare reassignment NPD Authorized official
• Berardis Family Chiropractic, PC

  • Chiropractor
  • Shrub Oak, NY
  • NPI 1942459326
  NPD Authorized official

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1225034564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 OLD YORKTOWN RD",
            "city": "SHRUB OAK",
            "state": "NY",
            "postal_code": "105881503",
            "telephone_number": "914-962-1234",
            "fax_number": "914-962-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3671 OLD YORKTOWN RD",
            "city": "SHRUB OAK",
            "state": "NY",
            "postal_code": "105881503",
            "telephone_number": "914-962-1234",
            "fax_number": "914-962-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERARDIS",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X-005871-1",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X005871-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI ID",
            "identifier": "0015178",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "C05871-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3I025202853",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID",
            "identifier": "P439476",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Berardis Family Chiropractic, PC
• Berardis Family Chiropractic, PC
• Jacqueline Ashley Brunell, PT, DPT
• Louise A Cashman, RN
• Vickie J Clark, RN
• Dalton Physical Therapy PLLC
• Margot Lynn Harrington

• Chiropractor in Shrub Oak, NY
• Providers in Shrub Oak, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.