Individual provider Active NPI

Michael John Berlin, DC

  • Chiropractor
  • Plainview, NY
National Provider Identifier
1619042843
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X006576-1 Issued in NY
Practice address
641 B Old Country Rd
Plainview, NY 11803
Phone
(516) 822-8499
Fax
(516) 822-5689
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X006576-1 NY Primary

Addresses

Primary practice location

641 B Old Country Rd
Plainview, NY 11803

Mailing address

641 B Old Country Rd
Plainview, NY 11803
Phone (516) 822-8499

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041104000532 NY Practitioner - Chiropractic 3678535051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

641 Old Country Rd
Suite B
Plainview, NY 11803-4933
Phone (516) 822-8499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X006576-1NYMDChiropractor

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619042843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 B OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-822-8499",
            "fax_number": "516-822-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 B OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-822-8499",
            "fax_number": "516-822-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLIN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X006576-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.