Organization Active NPI

Berks Plastic Surgery Institute PC

  • Plastic Surgery Physician
  • Wyomissing, PA
National Provider Identifier
1679695589
Registry record updated May 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
BERKS PLASTIC SURGERY INSTITUTE PC
Practice address
50 Commerce Dr
Wyomissing, PA 19610-3335
Phone
(610) 320-0200
Fax
(610) 320-9962
NPI assigned
Apr 4, 2007
Last updated
May 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2014

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

Authorized official

Name
Cindy Mountz
Title
Billing Coordinator
Phone
(610) 288-9965

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X PA Primary

Addresses

Primary practice location

50 Commerce Dr
Wyomissing, PA 19610-3335

Mailing address

50 Commerce Dr
Wyomissing, PA 19610-3335
Phone (610) 320-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040716000914 PA Part B Supplier - Clinic/Group Practice 6305825902 Receives reassigned benefits from 8 practitioners
Practice locations: Wyomissing, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2021224Berks Plastic Surgery Institute, PC50 Commerce Drive, Wyomissing, PA 19610ComplianceJun 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1679695589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 COMMERCE DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103335",
            "telephone_number": "610-320-0200",
            "fax_number": "610-320-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 COMMERCE DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103335",
            "telephone_number": "610-320-0200",
            "fax_number": "610-320-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKS PLASTIC SURGERY INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "MOUNTZ",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "610-288-9965"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.