David Berk
Individual provider Active NPI Chiropractor · Fairview, NJ
NPI 1831275940 · NPPES record last updated Oct 18, 2007
Key facts
- NPI
- 1831275940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38MC00601500 (NJ)
- Practice address
- 222 Bergen Blvd
Ste 8
Fairview, NJ 07022 - Phone
- (201) 945-1156
- Fax
- (201) 945-0012
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Physical Medicine Center of Fairview, LLC
Practice addresses (Care Compare)
222 Bergen Blvd
Suite 8
Fairview, NJ 07022-1300
Phone (201) 945-1156
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040607000858 | NJ | Practitioner - Chiropractic | 4688656192 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00601500 | NJ | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Medicine Center of Fairview, LLC | Chiropractor | Current |
Accepting new patients |
Locations
222 Bergen Blvd
Ste 8
Fairview, NJ 07022
Phone (201) 945-1156
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00601500 | NJ | Yes |
Addresses
Primary practice location
222 Bergen Blvd
Ste 8
Fairview, NJ 07022
Mailing address
222 Bergen Blvd
Ste 8
Fairview, NJ 07022
Phone (201) 945-1156
Other providers in Fairview, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.