Individual provider Active NPI

Pavel M Berklayd, MD

  • Anesthesiology Physician
  • Hartsdale, NY
National Provider Identifier
1659315265
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
248814 Issued in NY
Practice address
20 Lewis Ave
Hartsdale, NY 10530
Phone
(914) 629-9231
Fax
(718) 869-8506
NPI assigned
Jun 15, 2006
Last updated
Feb 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 248814 NY Primary

Addresses

Primary practice location

20 Lewis Ave
Hartsdale, NY 10530

Mailing address

20 Lewis Ave
Hartsdale, NY 10530
Phone (914) 629-9231

Other identifiers 1

IdentifierTypeStateIssuer
02362527MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090616000624 NY Practitioner - Anesthesiology 3779631346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Gastroenterology Consultants PCGroup PAC ID 8921999079, 13 clinicians

Practice addresses (Care Compare)

1111 Montauk Hwy
Suite 3
West Islip, NY 11795-4910
Phone (631) 669-1171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248814NYMDAnesthesiology Physician
001762NYMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Island Gastroenterology Consultants PC CurrentSince Jan 1, 2022 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

1111 Montauk Hwy
#3
West Islip, NY 11795
Phone (631) 669-1171

1111 Montauk Hwy
Ste 3
West Islip, NY 11795
Phone (631) 669-1171

1111 Montauk Hwy
Ste 31
West Islip, NY 11795
Phone (631) 669-1171

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1659315265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LEWIS AVE",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "10530",
            "telephone_number": "914-629-9231",
            "fax_number": "718-869-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LEWIS AVE",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "10530",
            "telephone_number": "914-629-9231",
            "fax_number": "718-869-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKLAYD",
        "first_name": "PAVEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "248814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02362527",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.