NPIMap

Organization Active NPI

Berks E.N.T. Surgical Associates, Inc.

  • Otolaryngology Physician
  • Wyomissing, PA
National Provider Identifier
1710959499
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
BERKS E.N.T. SURGICAL ASSOCIATES, INC.
Practice address
1 Granite Point Dr
Suite 300
Wyomissing, PA 19610-1986
Phone
(610) 376-9728
Fax
(610) 376-4780
NPI assigned
Feb 6, 2006
Last updated
Mar 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Authorized official

Name
Mrs. Cynthia A Garrett
Title
Administrator
Phone
(610) 376-3738

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

1 Granite Point Dr
Suite 300
Wyomissing, PA 19610-1986

Mailing address

1 Granite Point Dr
Suite 300
Wyomissing, PA 19610-1986
Phone (610) 376-9728

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000640 PA Part B Supplier - Clinic/Group Practice 5799773933 Receives reassigned benefits from 6 practitioners
Practice locations: Wyomissing, PA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1 Granite Point Dr
Ste 300
Wyomissing, PA 19610
Phone (610) 376-3738

Practitioners & affiliated clinicians

Practitioners 11

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": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363564800000",
    "number": "1710959499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GRANITE POINT DR",
            "address_2": "SUITE 300",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101986",
            "telephone_number": "610-376-9728",
            "fax_number": "610-376-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRANITE POINT DR",
            "address_2": "SUITE 300",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101986",
            "telephone_number": "610-376-9728",
            "fax_number": "610-376-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKS E.N.T. SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2013-03-18",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "610-376-3738",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "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 Mar 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.