Individual provider Active NPI

Gary D. Berman, M.D.

  • Clinical & Laboratory Immunology (Allergy & Immunology) Physician
  • Minneapolis, MN
National Provider Identifier
1609836121
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianTaxonomy code 207KI0005X
License
37947 Issued in MN
Practice address
825 Nicollet Mall
Suite 1149
Minneapolis, MN 55402-2606
Phone
(612) 338-3333
Fax
(612) 349-3838
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical & Laboratory Immunology (Allergy & Immunology) Physician 207KI0005X 37947 MN Primary

Addresses

Primary practice location

825 Nicollet Mall
Suite 1149
Minneapolis, MN 55402-2606

Mailing address

825 Nicollet Mall
Suite 1149
Minneapolis, MN 55402-2606
Phone (612) 338-3333

Other identifiers 1

IdentifierTypeStateIssuer
587225100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000809 MN Practitioner - Allergy/Immunology 4981667466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Mayo Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ear Nose and Throat Specialty Care of Minnesota PAGroup PAC ID 3274524020, 46 clinicians
Allergy and Asthma Specialists, PAGroup PAC ID 2466415930, 5 clinicians

Practice addresses (Care Compare)

6099 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-5538
Phone (612) 871-1144

825 Nicollet Mall
Suite 1149
Minneapolis, MN 55402-2750
Phone (612) 338-3333

Merit-based Incentive Payment System (MIPS)

Final score
77.11 of 100Reported as group
Quality
63.28
Promoting interoperability
91
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37947MNMDClinical & Laboratory Immunology (Allergy & Immunology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Specialty Care of Minnesota PA CurrentSince Jan 1, 2022 Accepting new patients
Allergy & Asthma Specialists, PA Clinical & Laboratory Immunology CurrentSince Jul 19, 1995 Accepting new patients

Locations

9550 Upland Ln N
Ste 200
Maple Grove, MN 55369
Phone (612) 871-1144

825 Nicollet Mall
Ste 1149
Minneapolis, MN 55402
Phone (612) 338-3333

2211 Park Ave
Minneapolis, MN 55404
Phone (612) 871-1144

6099 Wayzata Blvd
Ste 200
St Louis Park, MN 55416
Phone (612) 871-1144

Organizations & group practices 2

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1609836121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 NICOLLET MALL",
            "address_2": "SUITE 1149",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022606",
            "telephone_number": "612-338-3333",
            "fax_number": "612-349-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NICOLLET MALL",
            "address_2": "SUITE 1149",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022606",
            "telephone_number": "612-338-3333",
            "fax_number": "612-349-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "GARY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "MN",
            "license": "37947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "587225100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.