Active NPI
Joseph Berlenbach, P.A.
- Pediatrics Physician
- Derby, CT
National Provider Identifier
1801995675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 000253
- Practice address
- 130 Division St
Derby, CT 06418-1326 - Phone
- (203) 732-1330
- Fax
- (203) 732-1332
- NPI assigned
- Sep 21, 2006
- Last updated
- Oct 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 000253 | CT | Primary |
Addresses
Primary practice location
130 Division St
Derby, CT 06418-1326
Mailing address
67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-1330
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000253 | CT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1801995675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 MAPLE AVE",
"city": "DERBY",
"state": "CT",
"postal_code": "064181328",
"telephone_number": "203-732-1330",
"fax_number": "203-732-1332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 DIVISION ST",
"city": "DERBY",
"state": "CT",
"postal_code": "064181326",
"telephone_number": "203-732-1330",
"fax_number": "203-732-1332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLENBACH",
"first_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "000253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.