Individual provider Active NPI

Jeffrey L Berlant, M.D.

  • Psychiatry Physician
  • Novato, CA
National Provider Identifier
1720026495
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G28125 Issued in CA
Practice address
655 Canyon Rd
Novato, CA 94947-4331
Phone
(415) 892-1628
NPI assigned
Jun 3, 2006
Last updated
Mar 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M-5523 ID
Psychiatry Physician 2084P0800X G28125 CA Primary

Addresses

Primary practice location

655 Canyon Rd
Novato, CA 94947-4331

Mailing address

655 Canyon Rd
Novato, CA 94947-4331
Phone (415) 892-1628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170511002407 CA Practitioner - PsychiatryPractitioner - Internal Medicine 2163516220 Practice locations: Novato, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28125CAMDGeneral Practice Dentistry
G28125CAMDPsychiatry Physician
M-5523IDMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1720026495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 CANYON RD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474331",
            "telephone_number": "415-892-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 CANYON RD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474331",
            "telephone_number": "415-892-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLANT",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-5523",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G28125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.