Individual provider Active NPI

Wayne Michael Berkowitz, MD

  • Emergency Medicine Physician
  • Slidell, LA
National Provider Identifier
1225076169
Registry record updated Aug 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
024110 Issued in LA
Practice address
100 Medical Center Dr
Slidell, LA 70461-5520
Phone
(985) 646-5189
NPI assigned
Jun 3, 2006
Last updated
Aug 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 024110 LA Primary

Addresses

Primary practice location

100 Medical Center Dr
Slidell, LA 70461-5520

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other identifiers 1

IdentifierTypeStateIssuer
1489093MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20050311000130 LA Practitioner - Emergency Medicine 8224082326 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024110LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Parish Emergency Physicians Group LLC Emergency Medicine CurrentSince Nov 30, 2016 Accepting new patients
St Tammany Emergency Physicians Group LLC Emergency Medicine CurrentSince Mar 4, 2017 Accepting new patients
Foucher Emergency Physicians Emergency Medicine Past Accepting new patients
Louisiana Em-1 Medical Services, PA Past Accepting new patients
Louisiana Em-1 Medical Services, a Medical Corporation Emergency Medicine Past Accepting new patients

Locations

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

2929 Highway 190
Mandeville, LA 70471
Phone (985) 773-1550

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186099200000",
    "number": "1225076169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615520",
            "telephone_number": "985-646-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOWITZ",
        "first_name": "WAYNE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "024110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1489093",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.