Individual provider Active NPI

Berkley Calvin Curtis Jr., PA

  • Physician Assistant
  • Plantation, FL
National Provider Identifier
1245485424
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110411 Issued in FL
Practice address
8251 W Broward Blvd Ste 300
Plantation, FL 33324-2703
Phone
(544) 759-5359
Fax
(954) 475-4637
NPI assigned
Dec 1, 2008
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110411 FL Primary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X 005534 GA

Addresses

Primary practice location

8251 W Broward Blvd Ste 300
Plantation, FL 33324-2703

Mailing address

8251 W Broward Blvd Ste 300
Plantation, FL 33324-2703
Phone (544) 759-5359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005534GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Jan 19, 2009 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jan 19, 2009 Accepting new patients
Atlanta Pulmonary Group, LLC Past Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 4

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1245485424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8251 W BROWARD BLVD STE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242703",
            "telephone_number": "544-759-5359",
            "fax_number": "954-475-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8251 W BROWARD BLVD STE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242703",
            "telephone_number": "544-759-5359",
            "fax_number": "954-475-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CURTIS",
        "first_name": "BERKLEY",
        "middle_name": "CALVIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110411",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.