Individual provider Active NPI

Melissa Gail Berlin, MD

  • Family Medicine Physician
  • Glen Ridge, NJ
National Provider Identifier
1992029110
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09094700 Issued in NJ
Practice address
230 Sherman Ave
Glen Ridge, NJ 07028-1529
Phone
(973) 743-2321
Fax
(973) 259-0600
NPI assigned
Mar 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA09094700 NJ Primary

Addresses

Primary practice location

230 Sherman Ave
Glen Ridge, NJ 07028-1529

Mailing address

14-23 River Rd
Fair Lawn, NJ 07410-1240
Phone (201) 703-0600

Other names 1

  • Melissa Gail Rapoport Former name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09094700NJMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mberlin189423@ahs.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1992029110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14-23 RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101240",
            "telephone_number": "201-703-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 SHERMAN AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281529",
            "telephone_number": "973-743-2321",
            "fax_number": "973-259-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLIN",
        "first_name": "MELISSA",
        "middle_name": "GAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09094700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "RAPOPORT",
            "middle_name": "GAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.