Individual provider Active NPI

Stuart Douglas Berry, M.D.

  • Diagnostic Radiology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1225236524
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A102794 Issued in CA
Practice address
9320 Baseline Rd
Suit B1
Rancho Cucamonga, CA 91701-5829
Phone
(909) 466-4231
NPI assigned
Jul 7, 2007
Last updated
Oct 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X A102794 CA Primary

Addresses

Primary practice location

9320 Baseline Rd
Suit B1
Rancho Cucamonga, CA 91701-5829

Mailing address

9320 Baseline Rd
Suit B1
Rancho Cucamonga, CA 91701-5829
Phone (909) 466-4231

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
I20120619000083 CA Practitioner - Diagnostic Radiology 6406010719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Antonio Radiological MedicalGroup PAC ID 8325035942, 54 clinicians

Practice addresses (Care Compare)

999 San Bernardino Rd
Upland, CA 91786-4920
Phone (909) 985-2811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Radiological Medical Diagnostic Radiology CurrentSince Dec 1, 2012 Accepting new patients

Locations

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1225236524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 BASELINE RD",
            "address_2": "SUIT B1",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015829",
            "telephone_number": "909-466-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 BASELINE RD",
            "address_2": "SUIT B1",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015829",
            "telephone_number": "909-466-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "STUART",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-07",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A102794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.