Individual provider Active NPI

Steven Berry, MSN, FNP-BC

  • Family Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1629757307
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704324445 Issued in MI
Practice address
23721 Edward St
Dearborn, MI 48128-1280
Phone
(313) 445-8081
NPI assigned
Jul 12, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704324445NSA230IK MI
Family Nurse Practitioner 363LF0000X 4704324445 MI Primary

Addresses

Primary practice location

23721 Edward St
Dearborn, MI 48128-1280

Mailing address

23721 Edward St
Dearborn, MI 48128-1280
Phone (313) 445-8081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231104000682 MI Practitioner - Nurse Practitioner 6002263589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Knee Centers LLCGroup PAC ID 3779990098, 5 clinicians

Practice addresses (Care Compare)

26631 Southfield Rd
Lathrup Village, MI 48076-4530
Phone (877) 266-7563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704324445NSA230IKMIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Knee Centers LLC CurrentSince Sep 30, 2023 Accepting new patients

Locations

8726 NW 26th St
Ste 16
Doral, FL 33172
Phone (305) 477-7976

26631 Southfield Rd
Lathrup Village, MI 48076
Phone (248) 552-8195

1770 Fort St
Lincoln Park, MI 48146
Phone (313) 406-4413

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": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1629757307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23721 EDWARD ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281280",
            "telephone_number": "313-445-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23721 EDWARD ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281280",
            "telephone_number": "313-445-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "STEVEN",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704324445NSA230IK",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704324445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.