Active NPI
Robert Alan Berkowitz, D.D.S.
- Dentist
- Anderson, SC
National Provider Identifier
1982780029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3151
- Practice address
- 1221 N Fant St
Anderson, SC 29621 - Phone
- (864) 224-4736
- NPI assigned
- Oct 31, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 3151 | SC | Primary |
Addresses
Primary practice location
1221 N Fant St
Anderson, SC 29621
Mailing address
1221 N Fant St
Anderson, SC 29621
Phone (864) 224-4736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140424001905 | SC | Order and Referring Only - Oral Surgery | 1052544145 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3151 | SC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982780029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 N FANT ST",
"city": "ANDERSON",
"state": "SC",
"postal_code": "29621",
"telephone_number": "864-224-4736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 N FANT ST",
"city": "ANDERSON",
"state": "SC",
"postal_code": "29621",
"telephone_number": "864-224-4736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERKOWITZ",
"first_name": "ROBERT",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "3151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
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; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.