J Nickolas Berbos

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G054630 Issued in CA

Practice address

1400 N Harbor Blvd Ste 100
Fullerton, CA 92835-4107

Phone

(714) 879-0020

Fax

(714) 526-2020

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Louisville School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Omar Krad, M.D.

  • Ophthalmology Physician
  • Fullerton, CA
  • NPI 1669635132
  Medicare reassignment

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1467596114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N HARBOR BLVD STE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354107",
            "telephone_number": "714-879-0020",
            "fax_number": "714-526-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N HARBOR BLVD STE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354107",
            "telephone_number": "714-879-0020",
            "fax_number": "714-526-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBOS",
        "first_name": "J",
        "middle_name": "NICKOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G054630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G654300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riley Bennyworth
• James L Benoit, M.D.
• Fonteshia Benson
• Ricarda D Benz, M.D.
• Elizabeth Ann Berbos, D.M.D.
• Leslie Bergado
• Bryan Emmanuel Berges
• David Evan Bergman, DO
• Taylor Bergstedt
• Berke Dental Corporation

• Ophthalmology Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.
• 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.