Individual provider Active NPI

Jay Bradley Berkowitz, D.C

  • Chiropractor
  • Virginia Beach, VA
National Provider Identifier
1407992423
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556586 Issued in VA
Practice address
4867 Baxter Rd
Suite 107
Virginia Beach, VA 23462-4469
Phone
(757) 497-1555
Fax
(757) 497-2715
NPI assigned
Jan 29, 2007
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556586 VA Primary

Addresses

Primary practice location

4867 Baxter Rd
Suite 107
Virginia Beach, VA 23462-4469

Mailing address

4867 Baxter Rd Ste 107
Virginia Beach, VA 23462-4469
Phone (757) 497-8737

Other practice location 1

4224 Holland Rd Ste 110
Virginia Beach, VA 23452-1900
Phone (757) 486-4772

Other identifiers 1

IdentifierTypeStateIssuer
C03082OtherVAMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090826000204 VA Practitioner - Chiropractic 9638154388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4867 Baxter Rd
Suite 107
Virginia Beach, VA 23462-4469
Phone (757) 497-1555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jay B Berkowitz DC PC CurrentSince Aug 5, 2009 Accepting new patients
Peachtree Center Rehab LLC Chiropractor Past Accepting new patients
Peachtree Center Rehab Medical Services Chiropractor PastSince Aug 13, 2023 Accepting new patients

Locations

4224 Holland Rd
Ste 110
Virginia Beach, VA 23452
Phone (757) 486-4772

4867 Baxter Rd
Ste 107
Virginia Beach, VA 23462
Phone (757) 497-1555

Organizations & group practices 3

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1407992423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4867 BAXTER RD STE 107",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624469",
            "telephone_number": "757-497-8737",
            "fax_number": "757-497-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 BAXTER RD",
            "address_2": "SUITE 107",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624469",
            "telephone_number": "757-497-1555",
            "fax_number": "757-497-2715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4224 Holland Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234521900",
            "country_code": "US",
            "telephone_number": "757-486-4772",
            "fax_number": "757-486-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERKOWITZ",
        "first_name": "JAY",
        "middle_name": "BRADLEY",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "C03082",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.