NPIMap

Individual provider Active NPI

Kevin J Berry, M.D.

  • Interventional Cardiology Physician
  • Methuen, MA
National Provider Identifier
1487653861
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
48471 Issued in MA
Practice address
380 Merrimack St
Ste. 2D
Methuen, MA 01844-5870
Phone
(978) 794-0234
Fax
(978) 794-0560
NPI assigned
Jul 19, 2005
Last updated
Oct 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 48471 MA
Interventional Cardiology Physician 207RI0011X 48471 MA Primary

Addresses

Primary practice location

380 Merrimack St
Ste. 2D
Methuen, MA 01844-5870

Mailing address

380 Merrimack St
Ste. 2D
Methuen, MA 01844-5870
Phone (978) 794-0234

Other identifiers 2

IdentifierTypeStateIssuer
30006739MedicaidNH
0153109MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040930000899 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2466421938 Reassigns benefits to 2 organizations
Practice locations: Methuen, MA

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Vermont College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence General HospitalGroup PAC ID 5092725200, 124 clinicians
Community Medical Associates, Inc.Group PAC ID 6002946928, 155 clinicians

Practice addresses (Care Compare)

1 General St
Lawrence, MA 01841-2961
Phone 97868340002979

380 Merrimack St
Suite 2D
Methuen, MA 01844-5871
Phone (978) 794-0234

70 E St
Methuen, MA 01844-4597
Phone (978) 687-0151

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence General Hospital Current Accepting new patients
General Primary Care of Lawrence CurrentSince Aug 2, 2004 Accepting new patients
Lawrence General Hospital CurrentSince Aug 2, 2004 Accepting new patients
Northern Radiology Associates Past Accepting new patients
Kevin J. Berry, MD Cardiovascular Disease PastSince Jan 1, 1990 Accepting new patients

Locations

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

70 East St
Methuen, MA 01844
Phone (978) 682-1906

Interoperability endpoints

  • Direct secure messaging: kevin.berry.1@16045.direct.athenahealth.com

Organizations & group practices 6

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1487653861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "STE. 2D",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-794-0234",
            "fax_number": "978-794-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "STE. 2D",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-794-0234",
            "fax_number": "978-794-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "48471",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MA",
            "license": "48471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30006739",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0153109",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

Verify at the official NPI Registry.