Active NPI
Bert B Berlin, MD
- Urology Physician
- Hartford, CT
National Provider Identifier
1477553642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 010699
- Practice address
- 85 Seymour St
Suite 416
Hartford, CT 06106-5501 - Phone
- (860) 947-8500
- Fax
- (860) 524-8643
- NPI assigned
- Jul 28, 2005
- Last updated
- Jul 12, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 010699 | CT | Primary |
Addresses
Primary practice location
85 Seymour St
Suite 416
Hartford, CT 06106-5501
Mailing address
85 Seymour St
Suite 416
Hartford, CT 06106-5501
Phone (860) 947-8500
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4413115002 | Other | CT | CIGNA |
| 076037 | Other | CT | CONNECTICARE |
| 10567 | Other | CT | HEALTH NEW ENGLAND |
| P1096759 | Other | CT | OXFORD |
| 0S0304 | Other | CT | HEALTH NET |
| 010010699CT01 | Other | CT | ANTHEM BCBS |
| 2053926 | Other | CT | AETNA |
| 3164926 | Medicaid | MA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1477553642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 SEYMOUR ST",
"address_2": "SUITE 416",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061065501",
"telephone_number": "860-947-8500",
"fax_number": "860-524-8643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 SEYMOUR ST",
"address_2": "SUITE 416",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061065501",
"telephone_number": "860-947-8500",
"fax_number": "860-524-8643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLIN",
"first_name": "BERT",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-28",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CT",
"license": "010699",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4413115002",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "076037",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "10567",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P1096759",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "0S0304",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "010010699CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2053926",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3164926",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.