Active NPI
Mark Elliot Berman, PH.D.
- Clinical Psychologist
- Palmdale, CA
National Provider Identifier
1386651842
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Aug 18, 2011.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY9698
- Practice address
- 40413 Alabur Drive
Palmdale, CA 93551-1117 - Phone
- (661) 722-2987
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY9698 | CA | Primary |
Addresses
Primary practice location
40413 Alabur Drive
Palmdale, CA 93551-1117
Mailing address
40413 Alabur Drive
Palmdale, CA 93551-1117
Phone (661) 722-2987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY096981 | Medicaid | CA |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY9698 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242000000000",
"number": "1386651842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40413 ALABUR DRIVE",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935511117",
"telephone_number": "661-722-2987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40413 ALABUR DRIVE",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935511117",
"telephone_number": "661-722-2987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMAN",
"first_name": "MARK",
"middle_name": "ELLIOT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2009-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY9698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY096981",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.