Active NPI
John Matthew Bereza, PHD
- School Psychologist
- Columbus, OH
National Provider Identifier
1659033694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 272 S Front St Apt 415
Columbus, OH 43215-5104 - Phone
- (614) 299-9652
- NPI assigned
- Oct 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | OH | Primary |
Addresses
Primary practice location
272 S Front St Apt 415
Columbus, OH 43215-5104
Mailing address
272 S Front St Apt 415
Columbus, OH 43215-5104
Phone (614) 299-9652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633564800000",
"number": "1659033694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "272 S FRONT ST APT 415",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432155104",
"telephone_number": "614-299-9652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "272 S FRONT ST APT 415",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432155104",
"telephone_number": "614-299-9652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEREZA",
"first_name": "JOHN",
"middle_name": "MATTHEW",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-07",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.