Individual provider Active NPI

Jason B Berkebile, O.D.

  • Optometrist
  • Monroe, NC
National Provider Identifier
1609065077
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2079 Issued in NC
Practice address
1976 Wellness Blvd
Monroe, NC 28110
Phone
(954) 579-8576
NPI assigned
Oct 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2079 NC Primary

Addresses

Primary practice location

1976 Wellness Blvd
Monroe, NC 28110

Mailing address

2526 Cross Country Rd
Charlotte, NC 28270-0738
Phone (954) 579-8576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090624000289 NC Practitioner - Optometry 3173674629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1976 Wellness Blvd
Monroe, NC 28110-7763
Phone (704) 684-4190

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1825SCMDClinical Psychologist
2079NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Berkebile Eye Care OD PLLC Optometrist CurrentSince Nov 17, 2020 Accepting new patients

Locations

1976 Wellness Blvd
Monroe, NC 28110
Phone (704) 684-4190

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1609065077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 CROSS COUNTRY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282700738",
            "telephone_number": "954-579-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1976 WELLNESS BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "28110",
            "telephone_number": "954-579-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKEBILE",
        "first_name": "JASON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2021-03-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.