Michael Ezra Berry, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

245263 Issued in NY

Practice address

4037 74TH St
Elmhurst, NY 11373-5603

Phone

(718) 651-7000

Fax

(718) 606-8966

NPI assigned

Jul 25, 2007

Last updated

Nov 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Micahel Ezra Berry Other name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

State University of New York Downstate Medical Center, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahava Medical and Rehabilitation Center, LLCGroup PAC ID 1557416997, 150 clinicians

City Central Dermatology PLLCGroup PAC ID 9335317346, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellevue Hospital Center Hospital, New York, NY, CCN 330204

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: mberry322610@nychhc.direct-ci.com

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.

• City Central Dermatology PLLC

  • Specialist
  • Elmhurst, NY
  • NPI 1780977579
  Medicare reassignment Care Compare group NPD Authorized official
• Ahava Medical and Rehabilitation Center, LLC

  • Rehabilitation Practitioner
  • Brooklyn, NY
  • NPI 1184878274
  Medicare reassignment Care Compare group NPD
• Be Well Primary Health Care Center, LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1083623409
  Medicare reassignment NPD
• Richard S. Berry MDPC

  • Specialist
  • Brooklyn, NY
  • NPI 1952311946

  Dermatology

  Medicare reassignment NPD
• Meb Dermatology

  • Dermatology Physician
  • Brooklyn, NY
  • NPI 1932081999
  NPD
• Advanced Medical Associates of Westchester, PC

  • Legal Medicine
  • Yonkers, NY
  • NPI 1619101581
  NPD (past)
• Marina Matatova DO PC

  • Dermatology Physician
  • Brooklyn, NY
  • NPI 1578148185
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New York City Health and Hospitals Corporation

  dba Bellevue Hospital Center

  • General Acute Care Hospital
  • New York, NY
  • NPI 1073535027
  Care Compare affiliation

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1962692152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 74TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735603",
            "telephone_number": "718-651-7000",
            "fax_number": "718-606-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 74TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735603",
            "telephone_number": "718-651-7000",
            "fax_number": "718-606-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MICHAEL",
        "middle_name": "EZRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "245263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICAHEL",
            "last_name": "BERRY",
            "middle_name": "EZRA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lorenzo Raphael Palacios Bernal, PTA
• Bernard Abramovici
• Karla Bernardo, RN
• Margaret Ann Bernstein, LMSW
• Kenneth M Berry
• Linda Marie Bertschuk, O.D.
• Mirna B Beshay
• Best Choice Dental
• Best Rehab Care PT PC
• Dorcas Jeanine Bethel, LMSW

• Dermatology Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.