Individual provider Active NPI

Jerisa Berry, D.O.

  • Emergency Medicine Physician
  • Greenacres, FL
National Provider Identifier
1679760045
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS12892 Issued in FL
Practice address
2188 S Jog Rd
Greenacres, FL 33415-6101
Phone
(561) 429-3777
Fax
(561) 429-3565
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125049751 IL
Family Medicine Physician 207Q00000X 125049751 IL
Emergency Medicine Physician 207P00000X OS12892 FL Primary

Addresses

Primary practice location

2188 S Jog Rd
Greenacres, FL 33415-6101

Mailing address

2188 S Jog Rd
Greenacres, FL 33415-6101
Phone (561) 429-3777

Other identifiers 1

IdentifierTypeStateIssuer
036119674MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150609001130 FL Practitioner - Emergency Medicine 8426133406 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Care Medical Center IncGroup PAC ID 4284041500, 2 clinicians
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

2188 S Jog Rd
Greenacres, FL 33415-6101
Phone (561) 429-3777

6500 38TH Ave N
St. Petersburg General Hospital
Saint Petersburg, FL 33710-1629
Phone (727) 384-1414

Hospital & facility affiliations

  • HCA Florida Largo Hospital Hospital, Largo, FL, CCN 100248
  • HCA Florida South Tampa Hospital Hospital, Tampa, FL, CCN 100206
  • HCA Florida Osceola Hospital Hospital, Kissimmee, FL, CCN 100110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS12892FLMDEmergency Medicine Physician
125049751ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Emergency Physicians, LLC Emergency Medicine CurrentSince Feb 5, 2024 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince Mar 17, 2016 Accepting new patients
Pensacola Emergency Physicians, LLC Emergency Medicine Current Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Jun 14, 2024 Accepting new patients
Maximum Relief LLC PastSince Mar 27, 2019 Accepting new patients
Ashunti Residential Management Systems Past Accepting new patients
Midwest Physicians Network Inc Past Accepting new patients
Grant Advocate & Counseling SVC of Il PastSince Jan 1, 1990 Accepting new patients
Grant Advocate Illinois LLC PastSince Nov 8, 2009 Accepting new patients
Major Relief Inc PastSince Mar 25, 2019 Accepting new patients

Locations

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

6500 38th Ave N
St Petersburg, FL 33710
Phone (727) 341-4870

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

2201 45th St
West Palm Beach, FL 33407
Phone (561) 842-6141

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 11

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1679760045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2188 S JOG RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334156101",
            "telephone_number": "561-429-3777",
            "fax_number": "561-429-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2188 S JOG RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334156101",
            "telephone_number": "561-429-3777",
            "fax_number": "561-429-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JERISA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125049751",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125049751",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS12892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119674",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.