Gary M Berke Ms, CP

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CP1628

Legal business name

GARY M BERKE MS, CP

Practice address

2001 Winward Way
Suite 100
San Mateo, CA 94404-2499

Phone

(650) 365-5861

Fax

(650) 365-5896

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Gary M Berke, MS, CP

Title

Owner

Phone

(650) 365-5861

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Berke Prosthetics & Orthotics Doing business as

Locations

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467635367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 WINWARD WAY",
            "address_2": "SUITE 100",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944042499",
            "telephone_number": "650-365-5861",
            "fax_number": "650-365-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 WINWARD WAY",
            "address_2": "SUITE 100",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944042499",
            "telephone_number": "650-365-5861",
            "fax_number": "650-365-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY M BERKE MS, CP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-365-5861",
        "authorized_official_credential": "MS, CP"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": "CP1628",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": "CP1628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "XB0016280",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XB0016280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berke Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in San Mateo, CA
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.