Suzanne Katherine Mednik, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A134132 Issued in CA

Practice address

2001 Santa Monica Blvd Ste 990W
Santa Monica, CA 90404-2155

Phone

(310) 829-4484

NPI assigned

Mar 12, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Suzanne Katherine Berkovitz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1639595705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 WILSHIRE BLVD # 416",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 990W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042155",
            "telephone_number": "310-829-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDNIK",
        "first_name": "SUZANNE",
        "middle_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A134132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "BERKOVITZ",
            "middle_name": "KATHERINE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dermatology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.