Individual provider Active NPI

Clayton Michael Berger, MD

  • Ophthalmology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1285745679
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME51926 Issued in FL
Practice address
201 SE 14TH Street
Fort Lauderdale, FL 33316-1827
Phone
(954) 525-1111
Fax
(954) 522-5588
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME51926 FL Primary

Addresses

Primary practice location

201 SE 14TH Street
Fort Lauderdale, FL 33316-1827

Mailing address

201 SE 14TH Street
Fort Lauderdale, FL 33316-1827
Phone (954) 525-1111

Other identifiers 1

IdentifierTypeStateIssuer
061896900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040513000265 FL Practitioner - Ophthalmology 0446240477

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME51926FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley D Braverman MD LLC Ophthalmology PastSince Aug 13, 2003 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1285745679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SE 14TH STREET",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161827",
            "telephone_number": "954-525-1111",
            "fax_number": "954-522-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SE 14TH STREET",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161827",
            "telephone_number": "954-525-1111",
            "fax_number": "954-522-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "CLAYTON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME51926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061896900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.