Berkley Primary Care, PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BERKLEY PRIMARY CARE, PLC

Practice address

26711 Woodward Ave Ste 103
Huntington Woods, MI 48070-1367

Phone

(248) 543-6000

Fax

(248) 543-3770

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Terry S Vacheresse

Title

Office Manager

Phone

(248) 543-6000

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EDEEBA

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Anne Fulgenzi, MD

  • Internal Medicine Physician
  • Huntington Woods, MI
  • NPI 1962475236
  Medicare reassignment NPD
• Kathleen O'Neill, NP

  • Adult Health Nurse Practitioner
  • Huntington Woods, MI
  • NPI 1538571807
  NPD
• Valerie Lynn Johnson, MD

  • Internal Medicine Physician
  • Canton, MI
  • NPI 1568441491
  NPD (past)
• Karen Marie Swanson, MD

  • Internal Medicine Physician
  • Huntington Woods, MI
  • NPI 1972562031
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1316082399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26711 WOODWARD AVE STE 103",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701367",
            "telephone_number": "248-543-6000",
            "fax_number": "248-543-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26711 WOODWARD AVE STE 103",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701367",
            "telephone_number": "248-543-6000",
            "fax_number": "248-543-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKLEY PRIMARY CARE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "VACHERESSE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-543-6000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Umneet Kaur Banvait, DDS
• Daisy Vayesdy Barajas Mota, DMD
• Michelle Beth Bean, LMSW
• Berg Psychotherapy Associates PLLC
• Leticia Melanie Berg, MA, MLP
• Berlin Therapy PLLC
• Abigail Jane Berlin, LMSW
• Christopher Neil Biek, LCSW
• Haden Bighouse
• Daniel Blake, PH.D.

• Internal Medicine Physician in Huntington Woods, MI
• Providers in Huntington Woods, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.