Individual provider Active NPI

Elisabeth M Berry

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Montgomery, TX
National Provider Identifier
1851584726
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
1111342 Issued in TX
Practice address
750 Fish Creek Thoroughfare
Montgomery, TX 77316-6965
Phone
(936) 272-0790
NPI assigned
Aug 23, 2007
Last updated
May 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 1111342 TX Primary
Physical Therapist 225100000X 007742 OH
Physical Therapist 225100000X 61470 OR

Addresses

Primary practice location

750 Fish Creek Thoroughfare
Montgomery, TX 77316-6965

Mailing address

107 N Concord Valley Cir
Spring, TX 77382-1390
Phone (937) 344-9549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703001629 TX Practitioner - Physical Therapist in Private Practice 3173609963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6767 Lake Woodlands Dr
Suite F
The Woodlands, TX 77382-2566
Phone (281) 364-1122

Merit-based Incentive Payment System (MIPS)

Final score
81.05 of 100Reported as group
Quality
67.43
Promoting interoperability
100
Improvement activities
40
Cost
69.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1111342TXMDSports Medicine (Physical Medicine & Rehabilitation) Physician
007742OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Ridge Orthopaedics and Sports Medicine, LLC Sports Medicine CurrentSince Jun 1, 2024 Accepting new patients
Clackamas Sportscare LLC Physical Therapist Current Accepting new patients
Sterling Ridge Orthopaedics and Sports Medicine, LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

750 Fish Creek Thoroughfare
Montgomery, TX 77316
Phone (936) 272-0790

20639 Kuykendahl Rd
Ste 200
Spring, TX 77379
Phone (832) 698-0111

6767 Lake Woodlands Dr
#F
The Woodlands, TX 77382
Phone (281) 364-1122

Interoperability endpoints

  • Direct secure messaging: elisabeth.berry.1@1066.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1851584726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N CONCORD VALLEY CIR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773821390",
            "telephone_number": "937-344-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 FISH CREEK THOROUGHFARE",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773166965",
            "telephone_number": "936-272-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "ELISABETH",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "1111342",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "007742",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.