Individual provider Active NPI

Blake M Berman, MD

  • Diagnostic Radiology Physician
  • Deland, FL
National Provider Identifier
1487684239
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME97498 Issued in FL
Practice address
701 W Plymouth Ave
Deland, FL 32720-3236
Phone
(386) 943-3160
Fax
(317) 705-5047
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X 4301052661 MI
Diagnostic Radiology Physician 2085R0202X 4301052661 MI
Diagnostic Radiology Physician 2085R0202X ME97498 FL Primary

Addresses

Primary practice location

701 W Plymouth Ave
Deland, FL 32720-3236

Mailing address

4914 Pacifico CT
Palm Beach Gardens, FL 33418-8994
Phone (248) 310-3603

Other practice location 1

4914 Pacifico Ct
Palm Beach Gardens, FL 33418-8994
Phone (248) 310-3603

Other identifiers 2

IdentifierTypeStateIssuer
3056378MedicaidMI
3056387MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, NC, OK4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20100809001041 FL Practitioner - Diagnostic Radiology 8628961034 Reassigns benefits to 5 organizations
I20221003000410 TX Practitioner - Diagnostic Radiology 8628961034
I20221004003059 NC Practitioner - Diagnostic Radiology 8628961034
I20231102000628 OK Practitioner - Diagnostic Radiology 8628961034

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Imaging and Therapeutic Associates IncGroup PAC ID 1355254129, 92 clinicians

Practice addresses (Care Compare)

26 Lakeland Dr
Miramar Beach, FL 32550-4632
Phone (717) 932-5200

4914 Pacifico CT
Palm Beach Gardens, FL 33418-8994
Phone (717) 932-5200

Hospital & facility affiliations

  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067
  • Upmc Hanover Hospital, Hanover, PA, CCN 390233
  • Upmc Memorial Hospital, York, PA, CCN 390101
  • Upmc Carlisle Hospital, Carlisle, PA, CCN 390058
  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

Merit-based Incentive Payment System (MIPS)

Final score
81.93 of 100Reported as group
Quality
90.59
Improvement activities
40
Cost
57.01

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301052661MIMDNuclear Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 29, 2024 Accepting new patients
Singleton Associates PA Diagnostic Radiology CurrentSince Oct 29, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 29, 2024 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Nuclear Radiology CurrentSince Jan 29, 2024 Accepting new patients
Rapid Radiology, Inc. Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Quantum Imaging & Therapeutic Associates Inc Nuclear Radiology CurrentSince Sep 1, 2024 Accepting new patients
Michigan Diagnostic Imaging Diagnostic Radiology Past Accepting new patients
Diagnostic Radiology Associates of Flint PC Diagnostic Radiology Past Accepting new patients
Lifetest Michigan LLC Diagnostic Radiology Past Accepting new patients
Imaging Associates of Michigan PLLC Diagnostic Radiology Past Accepting new patients

Locations

555 Washington St
San Diego, CA 92103
Phone (619) 260-8300

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

1516 E Las Olas Blvd
Ft Lauderdale, FL 33301
Phone (954) 356-5142

900 Winderley Pl
Ste 1100
Maitland, FL 32751
Phone (407) 200-1606

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

765 W Nasa Blvd
Melbourne, FL 32901
Phone (321) 409-4044

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

3030 6th St S
St Petersburg, FL 33705
Phone (727) 894-8719

2401 S Side Blvd
Greensboro, NC 27406
Phone (336) 271-2800

351 S 40th St
Muskogee, OK 74401
Phone (918) 682-6161

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

6548 Comanche Trl
Ste 501
Austin, TX 78732

3698 620 S
Ste 110
Austin, TX 78738

4929 Burney Dr
Ste 120
Corpus Christi, TX 78411
Phone (512) 673-7552

3500 Gaston Ave
Dallas, TX 75246

815 8th Ave
Ft Worth, TX 76104
Phone (817) 332-4812

6441 Main St
Houston, TX 77030
Phone (713) 790-0500

205 Hollow Tree Ln
Houston, TX 77090
Phone (713) 807-8686

2121 Lohmans Crossing Rd
Ste 504
Lakeway, TX 78734
Phone (469) 420-0707

Organizations & group practices 12

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1487684239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 PACIFICO CT",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334188994",
            "telephone_number": "248-310-3603",
            "fax_number": "561-622-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203236",
            "telephone_number": "386-943-3160",
            "fax_number": "317-705-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4914 Pacifico Ct",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334188994",
            "country_code": "US",
            "telephone_number": "248-310-3603",
            "fax_number": "561-622-6399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "BLAKE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MI",
            "license": "4301052661",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301052661",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME97498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3056378",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3056387",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.