Individual provider Active NPI

Lauren Patricia Berman

  • Physician Assistant
  • Shirley, NY
National Provider Identifier
1497222129
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
800 Montauk Hwy Ste 18
Shirley, NY 11967-2128
Phone
(631) 772-4646
Fax
(631) 772-2495
NPI assigned
Oct 31, 2018
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

800 Montauk Hwy Ste 18
Shirley, NY 11967-2128

Mailing address

P.O. Box 1725
18 Post Fields Lane
Quogue, NY 11959
Phone (631) 902-4912

Other practice location 1

18 Post Fields Lane
Quogue, NY 11959
Phone (631) 902-4912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191022000236 NY Practitioner - Physician Assistant 6901138155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brookhaven Heart PLLCGroup PAC ID 6305846114, 24 clinicians

Practice addresses (Care Compare)

325 E Main St
Suite 120
Patchogue, NY 11772-3114
Phone (631) 654-3278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022975NYMDSpeech-Language Pathologist

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: lauren.berman@bh.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1497222129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1725",
            "address_2": "18 POST FIELDS LANE",
            "city": "QUOGUE",
            "state": "NY",
            "postal_code": "11959",
            "telephone_number": "631-902-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MONTAUK HWY STE 18",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672128",
            "telephone_number": "631-772-4646",
            "fax_number": "631-772-2495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Post Fields Lane",
            "address_purpose": "LOCATION",
            "city": "Quogue",
            "state": "NY",
            "postal_code": "11959",
            "country_code": "US",
            "telephone_number": "631-902-4912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "LAUREN",
        "middle_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.