Active NPI
Hermon Family Health Care
- Family Medicine Physician
- Hermon, NY
National Provider Identifier
1811057367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 158982-1
- Legal business name
- HERMON FAMILY HEALTH CARE
- Practice address
- 105 Main St
Hermon, NY 13652-3100 - Phone
- (315) 347-2191
- NPI assigned
- Dec 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Gary R Berk, M.D.
- Title
- M.D.
- Phone
- (315) 347-2191
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 158982-1 | NY | Primary |
Addresses
Primary practice location
105 Main St
Hermon, NY 13652-3100
Mailing address
1111 Patterson St
Ogdensburg, NY 13669-3840
Phone (315) 393-9113
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00986576 | Medicaid | NY | |
| 1417059718 | Other | NPI |
National Provider Directory
National Provider DirectoryLocations
105 Main St
Hermon, NY 13652
Phone (315) 347-2191
1111 Paterson St
Ogdensburg, NY 13669
Phone (315) 393-9113
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Canton, NY
- NPI 1801810304
-
- Clinical Pathology/Laboratory Medicine Physician
- Potsdam, NY
- NPI 1598829582
-
- Orthopaedic Surgery Physician
- Canton, NY
- NPI 1528131760
-
- Physical Medicine & Rehabilitation Physician
- Ogdensburg, NY
- NPI 1548324734
-
- Therapeutic Radiology Physician
- Pittsburgh, PA
- NPI 1518072701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1811057367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 PATTERSON ST",
"city": "OGDENSBURG",
"state": "NY",
"postal_code": "136693840",
"telephone_number": "315-393-9113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 MAIN ST",
"city": "HERMON",
"state": "NY",
"postal_code": "136523100",
"telephone_number": "315-347-2191"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HERMON FAMILY HEALTH CARE",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BERK",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "M.D.",
"authorized_official_telephone_number": "315-347-2191",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NY",
"license": "158982-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00986576",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1417059718",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Hermon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.