Individual provider Active NPI

Berenisis Lombert, MS SPC. EDU

  • Specialist
  • Mastic Beach, NY
National Provider Identifier
1609131002
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
SPEC EDU Issued in NY
Practice address
218 Wavecrest Dr
Mastic Beach, NY 11951-1502
Phone
(631) 721-8595
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X SPEC EDU NY Primary

Addresses

Primary practice location

218 Wavecrest Dr
Mastic Beach, NY 11951-1502

Mailing address

218 Wavecrest Dr
Mastic Beach, NY 11951-1502
Phone (631) 721-8595

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SPEC EDUNYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1609131002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 WAVECREST DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511502",
            "telephone_number": "631-721-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 WAVECREST DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511502",
            "telephone_number": "631-721-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBERT",
        "first_name": "BERENISIS",
        "name_prefix": "Ms.",
        "credential": "MS SPC. EDU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "SPEC EDU",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mastic Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.