Individual provider Active NPI

Dov J Berkowitz, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Kew Gardens, NY
National Provider Identifier
1255769519
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
152385-1 Issued in NY
Practice address
8002 Kew Gardens Rd
5-TH Floor
Kew Gardens, NY 11415-3600
Phone
(718) 575-5454
NPI assigned
Oct 24, 2013
Last updated
Oct 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 152385-1 NY Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 25MA09367300 NJ

Addresses

Primary practice location

8002 Kew Gardens Rd
5-TH Floor
Kew Gardens, NY 11415-3600

Mailing address

8002 Kew Gardens Rd
5-TH Floor
Kew Gardens, NY 11415-3600
Phone (718) 575-5454

Other identifiers 1

IdentifierTypeStateIssuer
00826480MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09367300NJMDSports Medicine (Orthopaedic Surgery) Physician
152385-1NYMDSports Medicine (Orthopaedic Surgery) Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1255769519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 KEW GARDENS RD",
            "address_2": "5-TH FLOOR",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153600",
            "telephone_number": "718-575-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 KEW GARDENS RD",
            "address_2": "5-TH FLOOR",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153600",
            "telephone_number": "718-575-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOWITZ",
        "first_name": "DOV",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "152385-1",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA09367300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00826480",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.