Active NPI
Aliza Black
- Physician Assistant
- Englewood, NJ
National Provider Identifier
1417387572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 017080
- Practice address
- 78 Franklin St
Englewood, NJ 07631-3616 - Phone
- (917) 776-8725
- NPI assigned
- Nov 26, 2013
- Last updated
- Apr 26, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 017080 | NY | Primary |
Addresses
Primary practice location
78 Franklin St
Englewood, NJ 07631-3616
Mailing address
78 Franklin St
Englewood, NJ 07631-3616
Phone (917) 776-8725
Other names 1
- Aliza Berkowitz
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017080 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amur Pike Emergency Physicians LLC | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Medical Physician Assistant
- Englewood, NJ
- NPI 1134701832
-
- Emergency Medicine Physician
- Secaucus, NJ
- NPI 1891198156
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1417387572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 FRANKLIN ST",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076313616",
"telephone_number": "917-776-8725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 FRANKLIN ST",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076313616",
"telephone_number": "917-776-8725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "ALIZA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-26",
"last_updated": "2021-04-26",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "017080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALIZA",
"last_name": "BERKOWITZ",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Englewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.