Jacob Berard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-31424 Issued in AZ

Practice address

13055 W McDowell Rd Ste G107
Avondale, AZ 85392-6450

Phone

(623) 547-4787

NPI assigned

Sep 25, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• N/a N/a Other name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• CSRM LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1669132353
  Medicare reassignment NPD
• Sawtooth Physical Therapy

  • Physical Therapy Clinic/Center
  • Boise, ID
  • NPI 1013206002

  Physical Therapist

  Medicare reassignment NPD
• CSRM LLC

  • Hand Occupational Therapist
  • Nampa, ID
  • NPI 1306583109
  NPD
• Sawtooth Physical Therapy

  • Hand Occupational Therapist
  • Meridian, ID
  • NPI 1003582040
  NPD

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1306453204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13055 W MCDOWELL RD STE G107",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853926450",
            "telephone_number": "623-547-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13055 W MCDOWELL RD STE G107",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853926450",
            "telephone_number": "623-547-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERARD",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ben Oris Inc.
• Ben-Ora, Hansen & Vanesian Imaging
• Madison Bender, RN, BSN, IBCLC
• Makayla Bennett
• Ashlynn Leeann Benson
• Gary Lee Berebitsky, MD
• Claudia Bermudez
• Megan L Bermudez, FNP-C, MSN, MBA
• Cinthia L. Bernal, L.P.C.
• Kimberlee Bernstein

• Physical Therapist in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.