Organization Active NPI

Zoya Berenson MD PC-Greater NE Medical Group

  • Multi-Specialty Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1407897903
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ZOYA BERENSON MD PC-GREATER NE MEDICAL GROUP
Practice address
2000 Grant Ave Ste 201
Philadelphia, PA 19115-4378
Phone
(215) 464-6104
Fax
(215) 464-9104
NPI assigned
Jun 8, 2006
Last updated
Mar 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Dr. Zoya Berenson, MDNPI 1457392862
Title
President
Phone
(215) 464-6104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

2000 Grant Ave Ste 201
Philadelphia, PA 19115-4378

Mailing address

2000 Grant Ave Ste 201
Philadelphia, PA 19115-4378
Phone (215) 464-6104

Other identifiers 1

IdentifierTypeStateIssuer
0017423170002MedicaidPA

Other names 1

  • Zoya Berenson MD PC-Greater NE Medical Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040809000135 PA Part B Supplier - Clinic/Group Practice 6709858012 Receives reassigned benefits from 5 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

2000 Grant Ave
Ste 201
Philadelphia, PA 19115
Phone (215) 464-6104

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1407897903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GRANT AVE STE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154378",
            "telephone_number": "215-464-6104",
            "fax_number": "215-464-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GRANT AVE STE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154378",
            "telephone_number": "215-464-6104",
            "fax_number": "215-464-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOYA BERENSON MD PC-GREATER NE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "BERENSON",
        "authorized_official_first_name": "ZOYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-464-6104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017423170002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zoya Berenson MD PC-Greater NE Medical Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Zoya Berenson MD PC-Greater NE Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.