Kenneth Alan Berlin, M.D.

Individual provider Active NPI Pediatrics Physician · Raynham, MA

NPI 1487622007 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1487622007
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
52899 (MA)
Practice address
876 Broadway
Raynham, MA 02767-1797
Phone
(508) 824-9500
Fax
(508) 824-9507
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52899MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raynham Taunton Pediatrics Pediatrics Past Accepting new patients
Tristan Medical Enterprises PC Past
since Nov 22, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 52899 MA Yes

Addresses

Primary practice location

876 Broadway
Raynham, MA 02767-1797

Mailing address

876 Broadway
Raynham, MA 02767-1797
Phone (508) 824-9500

Other identifiers

IdentifierTypeStateIssuer
6182747MedicaidMA

Other providers in Raynham, MA

All providers in Raynham, MA · Pediatrics Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.