Individual provider Active NPI

Ronald James Berry, P.T.

  • Physical Therapist
  • Santa Monica, CA
National Provider Identifier
1629295753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17150 Issued in CA
Practice address
427 Wilshire Blvd
Santa Monica, CA 90401-1409
Phone
(310) 656-8600
Fax
(310) 656-8606
NPI assigned
Apr 19, 2007
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
Physical Therapist 225100000X 17150 CA Primary

Addresses

Primary practice location

427 Wilshire Blvd
Santa Monica, CA 90401-1409

Mailing address

2534 Amherst Ave
Los Angeles, CA 90064-2712
Phone (310) 774-7625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181120002561 CA Practitioner - Physical Therapist in Private Practice 0345594750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Forster Physical Therapy IncGroup PAC ID 1759634868, 3 clinicians

Practice addresses (Care Compare)

427 Wilshire Blvd
Santa Monica, CA 90401-1409
Phone (310) 656-8604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forster Physical Therapy, Inc. Physical Therapist CurrentSince Sep 24, 2018 Accepting new patients

Locations

427 Wilshire Blvd
Santa Monica, CA 90401
Phone (310) 656-8600

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629295753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 AMHERST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642712",
            "telephone_number": "310-774-7625",
            "fax_number": "310-656-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 WILSHIRE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011409",
            "telephone_number": "310-656-8600",
            "fax_number": "310-656-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "RONALD",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "17150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

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.