Individual provider Active NPI

Alan Steven Berman, M.D

  • Emergency Medicine Physician
  • Lake Forest, CA
National Provider Identifier
1396773636
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G26936 Issued in CA
Practice address
22855 Lake Forest Dr Ste a
Lake Forest, CA 92630-1656
Phone
(949) 452-7544
NPI assigned
Jun 28, 2006
Last updated
Jan 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G26936 CA Primary

Addresses

Primary practice location

22855 Lake Forest Dr Ste a
Lake Forest, CA 92630-1656

Mailing address

2100 Powell St
Ste 920
Emeryville, CA 94608-1826
Phone (510) 350-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151229002492 TX Practitioner - Family Practice 5496722696 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G26936CAMDEmergency Medicine Physician
26936CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix CurrentSince Dec 3, 2015 Accepting new patients
DHHS IHS Phoenix Area Current Accepting new patients

Organizations & group practices 2

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1396773636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22855 LAKE FOREST DR STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301656",
            "telephone_number": "949-452-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "ALAN",
        "middle_name": "STEVEN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G26936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

Verify at the official NPI Registry.