Justin M Berman, PA-C
Individual provider Active NPI Physician Assistant · Harrisburg, PA
NPI 1497010664 · NPPES record last updated Jul 12, 2012
Key facts
- NPI
- 1497010664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- MA05563 (PA)
- Practice address
- 1821 Fulton St
Harrisburg, PA 17102-1522 - Phone
- (717) 230-2909
- NPI assigned
- Jul 12, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hamilton Health Center, Inc.
Practice addresses (Care Compare)
110 S 17TH St
Harrisburg, PA 17104-1123
Phone (717) 230-3906
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260225001643 | PA | Practitioner - Physician Assistant | 2264659457 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA05563 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hamilton Health Center, Inc. | Current |
Accepting new patients | |
| Hamilton Health Center, Inc | Current |
Accepting new patients | |
| CRHS@ Hamilton Health Center | Past | Accepting new patients |
Locations
110 S 17th St
Harrisburg, PA 17104
Phone (717) 230-3906
1821 Fulton St
Harrisburg, PA 17102
Phone (717) 230-3906
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA05563 | PA | Yes |
Addresses
Primary practice location
1821 Fulton St
Harrisburg, PA 17102-1522
Mailing address
1761 Marilyn Dr
Havertown, PA 19083-1226
Phone (610) 609-9194
NPI Registry JSON
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1497010664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1761 MARILYN DR",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190831226",
"telephone_number": "610-609-9194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1821 FULTON ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171021522",
"telephone_number": "717-230-2909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMAN",
"first_name": "JUSTIN",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-12",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA05563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, PA
- Michael Scott Bentz
- Lisa Ann Berg
- Alissa Kate Bergstresser
- Luke Borden Berguson
- Diana Berkstresser
- Catharine Ellen Bernal
- Ann F. Bero
- Jennifer Berry
- Katelyn Berry
- Katherine A Berry
All providers in Harrisburg, PA · Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.