Individual provider Active NPI

Eric Berends

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1750434163
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
015570-1 Issued in NY
Practice address
103 White Spruce Blvd
Rochester, NY 14623-1610
Phone
(585) 292-5830
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 015570-1 NY Primary

Addresses

Primary practice location

103 White Spruce Blvd
Rochester, NY 14623-1610

Mailing address

12 Thistlewood LN
Spencerport, NY 14559-1712

Other identifiers 2

IdentifierTypeStateIssuer
PREFERRED CAREOtherNYMDJ032
AETNAOtherNY1183166

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

LicenseStateTypeSpecialty
015570-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750434163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 THISTLEWOOD LN",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231610",
            "telephone_number": "585-292-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERENDS",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015570-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDJ032",
            "identifier": "PREFERRED CARE",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1183166",
            "identifier": "AETNA",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.