NPIMap

Individual provider Active NPI

Tamara Marie Berry

  • Dermatology Physician
  • Santa Barbara, CA
National Provider Identifier
1407112212
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A150443 Issued in CA
Practice address
317 W Pueblo St
Santa Barbara, CA 93105
Phone
(805) 898-3050
NPI assigned
Apr 5, 2012
Last updated
Jun 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A150443 CA Primary
Dermatology Physician 207N00000X MD457359 PA

Addresses

Primary practice location

317 W Pueblo St
Santa Barbara, CA 93105

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-7800

Other practice location 1

115 Woodbine Lane
Danville, PA 17822-0001
Phone (570) 271-8050

Other identifiers 1

IdentifierTypeStateIssuer
A150443OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171030000664 CA Practitioner - Dermatology 6901190172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of New Mexico School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

317 W Pueblo St
Santa Barbara, CA 93105-4310
Phone (805) 681-7500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision43
Removal of skin lesions1488
Removal or shaving of skin growth1-10
Skin biopsy490

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A150443CAMDDermatology Physician
MD457359PAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Sep 6, 2017 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Sep 6, 2017 Accepting new patients
Community Medical Center Past Accepting new patients
Geisinger Medical Center Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Sansum Clinic Past Accepting new patients
Goleta Valley Cottage Hospital Past Accepting new patients
Geisinger Bloomsburg Hospital Past Accepting new patients
Geisinger Lewistown Hospital Past Accepting new patients
Geisinger Health System Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

317 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 681-7500

Interoperability endpoints

  • Direct secure messaging: tberry760377@hisp.ehr.sutterhealth.org

Organizations & group practices 11

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1407112212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-898-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Woodbine Lane",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178220001",
            "country_code": "US",
            "telephone_number": "570-271-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "TAMARA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A150443",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD457359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A150443",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.