Individual provider Active NPI

Michael J Berman, OD

  • Optometrist
  • Spring Valley, NY
National Provider Identifier
1588971105
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TU005390 Issued in NY
Practice address
10 Spring Valley Market PL
Spring Valley, NY 10977-5209
Phone
(845) 426-3937
Fax
(845) 426-3937
NPI assigned
Sep 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TU005390 NY Primary

Addresses

Primary practice location

10 Spring Valley Market PL
Spring Valley, NY 10977-5209

Mailing address

10 Spring Valley Market PL
Spring Valley, NY 10977-5209
Phone (845) 426-3937

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915002795 NY Order and Referring Only - OptometryPractitioner - Optometry 6103133756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TU005390NYMDOptometrist
005390NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Scoda Corp Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1588971105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SPRING VALLEY MARKET PL",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775209",
            "telephone_number": "845-426-3937",
            "fax_number": "845-426-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SPRING VALLEY MARKET PL",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775209",
            "telephone_number": "845-426-3937",
            "fax_number": "845-426-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-02",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TU005390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

Verify at the official NPI Registry.