Active NPI
Ronald Berenson, M.D.
- Physiological Laboratory
- Seattle, WA
National Provider Identifier
1952777427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physiological Laboratory
- License
- MD 00022209
- Practice address
- 2032 41St Avenue
Seattle, WA 98112 - Phone
- (206) 790-1094
- Fax
- (206) 236-1836
- NPI assigned
- Aug 19, 2015
- Last updated
- Aug 19, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physiological Laboratory | 293D00000X | MD 00022209 | WA | Primary |
Addresses
Primary practice location
2032 41St Avenue
Seattle, WA 98112
Mailing address
PO Box 1597
Mercer Island, WA 98040-1597
Phone (206) 790-1094
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 00022209 | WA | MD | Physiological Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439942400000",
"number": "1952777427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1597",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980401597",
"telephone_number": "206-790-1094",
"fax_number": "206-236-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2032 41ST AVENUE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98112",
"telephone_number": "206-790-1094",
"fax_number": "206-236-1836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERENSON",
"first_name": "RONALD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-19",
"last_updated": "2015-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "293D00000X",
"taxonomy_group": "",
"desc": "Physiological Laboratory",
"state": "WA",
"license": "MD 00022209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.