Individual provider Active NPI

Leo E Berkenbile, MD

  • Emergency Medicine Physician
  • Glendale, CA
National Provider Identifier
1518090760
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
158554-1205 Issued in UT
Practice address
1812 Verdugo Blvd
Verdugo Hills Hospital ER
Glendale, CA 91208-1409
Phone
(818) 952-2222
NPI assigned
Mar 14, 2007
Last updated
Mar 7, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G31523 CA
Emergency Medicine Physician 207P00000X 158554-1205 UT Primary

Addresses

Primary practice location

1812 Verdugo Blvd
Verdugo Hills Hospital ER
Glendale, CA 91208-1409

Mailing address

3800 La Crescenta Ave
#207
La Crescenta, CA 91214-3924
Phone (818) 957-9595

Other identifiers 1

IdentifierTypeStateIssuer
00G315230MedicaidCA

Medicare participation

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Specialists LLC Past Accepting new patients
Foothill Emergency Physicians Emergency Medicine PastSince Mar 2, 2004 Accepting new patients

Organizations & group practices 3

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1518090760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 LA CRESCENTA AVE",
            "address_2": "#207",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143924",
            "telephone_number": "818-957-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 VERDUGO BLVD",
            "address_2": "VERDUGO HILLS HOSPITAL ER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081409",
            "telephone_number": "818-952-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKENBILE",
        "first_name": "LEO",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G31523",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "158554-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G315230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.