Individual provider Active NPI

Leonard Alan Berkowitz, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1740430800
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4290 Issued in AZ
Practice address
2 Richmond SQ Ste 110
Providence, RI 02906-5135
Phone
(401) 414-1400
Fax
(401) 414-1401
NPI assigned
Sep 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4290 AZ Primary

Addresses

Primary practice location

2 Richmond SQ Ste 110
Providence, RI 02906-5135

Mailing address

2 Richmond SQ Ste 110
Providence, RI 02906-5135
Phone (401) 414-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228002417 RI Practitioner - Physician Assistant 5597806778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Richmond SQ
Suite 110
Providence, RI 02906-5135
Phone (401) 414-1400

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metrowest Urologic Associates PC PastSince Dec 1, 2017 Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc05634_metrowesturologicassoc
  • FHIR API: https://fhir4.healow.com/fhir/r4/DHFICD/Endpoint/DHFICD

Organizations & group practices 2

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 1

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": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1740430800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RICHMOND SQ STE 110",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065135",
            "telephone_number": "401-414-1400",
            "fax_number": "401-414-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RICHMOND SQ STE 110",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065135",
            "telephone_number": "401-414-1400",
            "fax_number": "401-414-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOWITZ",
        "first_name": "LEONARD",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.