Individual provider Active NPI

Mikhail N Berman, M.D.

  • Family Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1629011887
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0045620 Issued in FL
Practice address
8295 North Military Trail
Suite G
Palm Beach Gardens, FL 33410
Phone
(561) 626-3205
Fax
(888) 959-2478
NPI assigned
Jun 14, 2006
Last updated
Jun 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0045620 FL Primary

Addresses

Primary practice location

8295 North Military Trail
Suite G
Palm Beach Gardens, FL 33410

Mailing address

8295 North Military Trail
Suite G
Palm Beach Gardens, FL 33410
Phone (561) 626-3205

Other practice location 1

12901 NW 27 Ave
Miami, FL 33167
Phone (305) 681-2855

Other identifiers 1

IdentifierTypeStateIssuer
044198800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151228001079 FL Order and Referring Only - Family PracticePractitioner - Family Practice 4587842000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0045620FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Multispecialty Associates LLC Family Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1629011887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8295 NORTH MILITARY TRAIL",
            "address_2": "SUITE G",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-626-3205",
            "fax_number": "888-959-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8295 NORTH MILITARY TRAIL",
            "address_2": "SUITE G",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-626-3205",
            "fax_number": "888-959-2478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12901 NW 27 Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33167",
            "country_code": "US",
            "telephone_number": "305-681-2855",
            "fax_number": "305-681-4533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "MIKHAIL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0045620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044198800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.