Active NPI
Sarah Berkowitz
- Registered Dietitian
- Lake Elmo, MN
National Provider Identifier
1720682628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3584
- Practice address
- 11063 11TH St N
Lake Elmo, MN 55042-9649 - Phone
- (651) 497-1613
- NPI assigned
- Nov 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2944-29 | WI | |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | |||
| Registered Dietitian | 133V00000X | 3584 | MN | Primary |
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | |||
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X |
Addresses
Primary practice location
11063 11TH St N
Lake Elmo, MN 55042-9649
Mailing address
11063 11TH St N
Lake Elmo, MN 55042-9649
Phone (651) 497-1613
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2944-29 | Other | WI | WISCONSIN BOARD OF SAFETY AND PROFESSIONAL SERVICES |
| 3584 | Other | MN | MINNESOTA BOARD OF DIETETICS AND NUTRITION SERVICES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2944-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1720682628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11063 11TH ST N",
"city": "LAKE ELMO",
"state": "MN",
"postal_code": "550429649",
"telephone_number": "651-497-1613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11063 11TH ST N",
"city": "LAKE ELMO",
"state": "MN",
"postal_code": "550429649",
"telephone_number": "651-497-1613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERKOWITZ",
"first_name": "SARAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2944-29",
"primary": false
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "3584",
"primary": true
},
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1501X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN BOARD OF SAFETY AND PROFESSIONAL SERVICES",
"identifier": "2944-29",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA BOARD OF DIETETICS AND NUTRITION SERVICES",
"identifier": "3584",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Elmo, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.