Individual provider Active NPI

Daniel Samuel Berliner, M.D.

  • Emergency Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1649260613
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR 0020914 Issued in CO
Practice address
3205 N Academy Blvd
Suite 160
Colorado Springs, CO 80917-5101
Phone
(719) 776-3216
Fax
(719) 776-3187
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G41348 CA
Emergency Medicine Physician 207P00000X DR 0020914 CO Primary

Addresses

Primary practice location

3205 N Academy Blvd
Suite 160
Colorado Springs, CO 80917-5101

Mailing address

417 E Kiowa St
#1202
Colorado Springs, CO 80903-3410
Phone (719) 434-7219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20131023001021 CO Practitioner - Preventive MedicinePractitioner - Emergency Medicine 5092782599 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G41348CAMDEmergency Medicine Physician
DR 0020914COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews-Vu Medical Group, P.C. CurrentSince Sep 1, 2016 Accepting new patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Sep 1, 2016 Accepting new patients
Oakdale Medical Group Inc Emergency Medicine Past Accepting new patients

Locations

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

Organizations & group practices 4

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1649260613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E KIOWA ST",
            "address_2": "#1202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033410",
            "telephone_number": "719-434-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "SUITE 160",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175101",
            "telephone_number": "719-776-3216",
            "fax_number": "719-776-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLINER",
        "first_name": "DANIEL",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G41348",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR 0020914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.