Active NPI
Samuel Berman
- Internal Medicine Physician
- Fort Snelling, MN
National Provider Identifier
1437330941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 16920
- Practice address
- 1 Fed Dr Suite 3300
BHW Fed BLDG
Fort Snelling, MN 55111 - Phone
- (612) 725-1789
- Fax
- (612) 725-1788
- NPI assigned
- Nov 27, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16920 | MN | Primary |
Addresses
Primary practice location
1 Fed Dr Suite 3300
BHW Fed BLDG
Fort Snelling, MN 55111
Mailing address
5644 Bloomington Ave
Minneapolis, MN 55417-2641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16920 | MN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196121600000",
"number": "1437330941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5644 BLOOMINGTON AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554172641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 FED DR SUITE 3300",
"address_2": "BHW FED BLDG",
"city": "FORT SNELLING",
"state": "MN",
"postal_code": "55111",
"telephone_number": "612-725-1789",
"fax_number": "612-725-1788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMAN",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-27",
"last_updated": "2007-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "16920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Snelling, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.