Individual provider Active NPI

Robert Douglas Berney, D.C.

  • Chiropractor
  • Smithtown, NY
National Provider Identifier
1902907017
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X002930-1 Issued in NY
Practice address
61 Route 111
Smithtown, NY 11787-3712
Phone
(631) 360-7733
Fax
(631) 360-7786
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

61 Route 111
Smithtown, NY 11787-3712
Phone (631) 360-7733

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20071025000167 NY Practitioner - Chiropractic 1557458429 Practice locations: Smithtown, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X002930-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert D. Berney Chiropractor PastSince Jan 1, 1990 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X002930-1 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

61 Route 111
Smithtown, NY 11787-3712

Mailing address

61 Rte 111
Smithtown, NY 11787
Phone (631) 360-7733

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902907017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 RTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-360-7733",
            "fax_number": "631-360-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873712",
            "telephone_number": "631-360-7733",
            "fax_number": "631-360-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNEY",
        "first_name": "ROBERT",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X002930-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.