Organization Active NPI

Lance Berlin DPM PC

  • Podiatrist
  • Islip, NY
National Provider Identifier
1598943102
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N0047041 Issued in NY
Legal business name
LANCE BERLIN DPM PC
Practice address
2330 Union Blvd
Islip, NY 11751-3103
Phone
(631) 277-8900
NPI assigned
Feb 6, 2008
Last updated
Apr 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Lance Berlin, MDNPI 1942262241
Title
Owner
Phone
(631) 277-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N0047041 NY Primary

Addresses

Primary practice location

2330 Union Blvd
Islip, NY 11751-3103

Mailing address

2330 Union Blvd
Islip, NY 11751-3103
Phone (631) 277-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110419000006 NY Part B Supplier - Clinic/Group Practice 7416078043 Receives reassigned benefits from 7 practitioners
Practice locations: Islip, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1598943102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 UNION BLVD",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513103",
            "telephone_number": "631-277-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 UNION BLVD",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513103",
            "telephone_number": "631-277-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCE BERLIN DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "BERLIN",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-277-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N0047041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.