Individual provider Active NPI

Julie Ann Berry, M.D.

  • Otolaryngology Physician
  • Oceanside, CA
National Provider Identifier
1699724666
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A94101 Issued in CA
Practice address
3909 Waring Rd Ste a
Oceanside, CA 92056-4455
Phone
(760) 726-2440
NPI assigned
May 8, 2006
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A94101 CA Primary

Addresses

Primary practice location

3909 Waring Rd Ste a
Oceanside, CA 92056-4455

Mailing address

1152 Loma Vista Way
Vista, CA 92084-7302
Phone (760) 420-0725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20240605001425 DE Practitioner - Otolaryngology 3779586375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

200 Federal St
Seaford, DE 19973-5764
Phone (410) 912-4976

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94101CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Specialty Care, LLC CurrentSince Jun 30, 2024 Accepting new patients
Scripps Health Current Accepting new patients
Tidalhealth Physician Network, Inc. CurrentSince Jun 12, 2024 Accepting new patients

Locations

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

200 Federal St
Seaford, DE 19973
Phone (302) 629-9099

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jberry80814@scrippshlth.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1699724666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 LOMA VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920847302",
            "telephone_number": "760-420-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 WARING RD STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564455",
            "telephone_number": "760-726-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A94101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.