Organization Active NPI

Bereskin and Associates PC

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1881793891
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33655 Issued in CO
Legal business name
BERESKIN AND ASSOCIATES PC
Practice address
1850 Bassett St
404
Denver, CO 80202-1048
Phone
(720) 273-9598
Fax
(303) 974-1122
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Dr. Gayle Frankie Bereskin, D.O.
Title
Medical Director
Phone
(720) 273-9598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 33655 CO Primary

Addresses

Primary practice location

1850 Bassett St
404
Denver, CO 80202-1048

Mailing address

1850 Bassett St
404
Denver, CO 80202-1048
Phone (720) 273-9598

Other identifiers 1

IdentifierTypeStateIssuer
01336551MedicaidCO

Other names 1

  • Boulder Integrative Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

5387 Manhattan Cir
Ste 202
Boulder, CO 80303
Phone (303) 499-0044

5589 Arapahoe Ave
Ste 201
Boulder, CO 80303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1881793891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BASSETT ST",
            "address_2": "404",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021048",
            "telephone_number": "720-273-9598",
            "fax_number": "303-974-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BASSETT ST",
            "address_2": "404",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021048",
            "telephone_number": "720-273-9598",
            "fax_number": "303-974-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERESKIN AND ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "BERESKIN",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "FRANKIE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "720-273-9598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "33655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01336551",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulder Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.