Organization Active NPI

Mark Berman,MD,PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Hackensack, NJ
National Provider Identifier
1578867917
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
25MA04662200 Issued in NJ
Legal business name
MARK BERMAN,MD,PA
Practice address
211 Essex St
Suite 402
Hackensack, NJ 07601-3231
Phone
(201) 489-8250
Fax
(201) 489-2933
NPI assigned
Dec 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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

Authorized official

Name
Mark Berman, M.D.,P.A.
Title
Orthopedic Surgeon
Phone
(201) 489-8250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X 25MA04662200 NJ Primary

Addresses

Primary practice location

211 Essex St
Suite 402
Hackensack, NJ 07601-3231

Mailing address

211 Essex St
Suite 402
Hackensack, NJ 07601-3231
Phone (201) 489-8250

Other identifiers 1

IdentifierTypeStateIssuer
0301809MedicaidNJ

National Provider Directory

National Provider Directory

Locations

920 Main St
Ste 2
Hackensack, NJ 07601
Phone (201) 489-8250

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1578867917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 ESSEX ST",
            "address_2": "SUITE 402",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013231",
            "telephone_number": "201-489-8250",
            "fax_number": "201-489-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 ESSEX ST",
            "address_2": "SUITE 402",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013231",
            "telephone_number": "201-489-8250",
            "fax_number": "201-489-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK BERMAN,MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "BERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ORTHOPEDIC SURGEON",
        "authorized_official_telephone_number": "201-489-8250",
        "authorized_official_credential": "M.D.,P.A."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA04662200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0301809",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; 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.