DR. ROBERT BERKE (NPI# 1720057599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720057599 |
| Entity Type | Individual |
| Full Name | DR. ROBERT BERKE |
| Credential | M.D. |
| Practice Address |
95 E Chautauqua St Mayville NY 14757-0168 |
| Mailing Address |
95 E Chautauqua St Po Box 168 Mayville NY 14757-1017 |
| Practice Telephone | 7167537107 |
| Practice Fax Number | 7167537980 |
| Mailing Telephone | 7167537107 |
| Mailing Fax Number | 7167537980 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2015-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
150109 | NY | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 150109 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | UNIVERA | 00010196403 | 01 |
| NY | BCBSWNY | 000508622007 | 01 |
| NY | INDEPENDENT HEALTH | 6402758 | 01 |
| NY | 00723491 | 05 |
| Street Address |
95 E CHAUTAUQUA ST |
| City | MAYVILLE |
| State | NY |
| Zip Code | 14757-0168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437140423 | Stephanie Redlecki | Physician Assistant | 95 E Chautauqua St, Mayville, NY 14757-0168 | 2005-10-31 |
| 1316468853 | Katherine Meleen | Nurse Practitioner | 95 E Chautauqua St, Mayville, NY 14757-1017 | 2017-07-06 |
| 1851610950 | Jeremy Martin Riedesel | Family Medicine | 95 E Chautauqua St, Mayville, NY 14757-0168 | 2010-05-28 |
| 1467487413 | Connie Jo Tonger | Nurse Practitioner | 95 E Chautauqua St, Mayville, NY 14757 | 2006-07-11 |
| 1932151438 | Robert Berke Md | Family Medicine | 95 E Chautauqua St, Mayville, NY 14757-1017 | 2006-05-16 |
| 1285603548 | Michael F Ludwig | Physician Assistant | 95 E Chautauqua St, Mayville, NY 14757-0168 | 2006-03-17 |
| 1346219656 | Roderic T Hunt | Physician Assistant | 95 E Chautauqua St, Mayville, NY 14757-0168 | 2006-03-17 |
| 1144299827 | Wendy Chase | Physician Assistant | 95 E Chautauqua St, Mayville, NY 14757-1017 | 2006-03-16 |
| 1851360606 | Alexander Z Selioutski | Family Medicine | 95 E Chautauqua St, Mayville, NY 14757-0168 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144598129 | Michele Therese Jones | Speech-Language Pathologist | 100 North Erie Street, Chautauqua Lake Central School-erie 2 Boces Program, Mayville, NY 14757 | 2011-12-06 |
| 1043351935 | Melody A Dejohn | Counselor | 99 S Erie St, Mayville, NY 14757 | 2007-02-12 |
| 1386794006 | Vivian Karen Gerard | Counselor | 7 North Erie Street, Mayville, NY 14757 | 2007-01-12 |
| 1104150507 | Jerome Thomas Scholl | Dentist | 126 W. Lake Rd., Mayville, NY 14757-0000 | 2009-10-01 |
| 1932355229 | Wallace B Johnson | Dentist | West Lake Road, Mayville, NY 14757-0126 | 2008-08-18 |
| 1528345469 | Sarah Ann Uebelhoer | Physician Assistant | 95 East Chautauqua St, Mayville, NY 14757-0168 | 2011-11-07 |
| 1619072204 | Family Health Medical Services Pllc | Family Medicine | 95 East Chautauqua St., Mayville, NY 14757-0168 | 2006-09-14 |
| 1972572691 | Roy M Sleboda | Physician Assistant | 95 E Chautauqua St., Mayville, NY 14757-0168 | 2006-03-15 |
| 1952384844 | Ralph Gerald Walton | Psychiatry & Neurology | 95 East Chautauqua Street, Mayville, NY 14757-0168 | 2005-11-23 |
| 1396034252 | Karen A Thomas | Licensed Practical Nurse | 64 E Chautauqua St, Mayville, NY 14757-1005 | 2011-03-31 |
| Find all providers in zip 14757 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
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| 1891304325 | Christopher R. Page, M.d., Pllc | General Practice | 46 Route 25a Ste 6, Setauket, NY 11733-2807 | 2020-07-30 |
| 1740804442 | Aliza Hakimian | General Practice | 15 Hill Park Ave Apt 2n, Great Neck, NY 11021-3709 | 2020-05-29 |
| 1962022152 | Lynnette Lallave - Cortes | General Practice | 2 Seaman Ave Apt 1d, New York, NY 10034-2904 | 2020-04-17 |
| 1942829759 | Northeasttelemedicine | General Practice | 483 Coolidge Hill Rd, Diamond Point, NY 12824 | 2020-04-11 |
| 1578198826 | Online Care Medicine PC | General Practice | 26 Oldox Rd, Delmar, NY 12054-2943 | 2020-03-06 |
| 1821621301 | Donnet Andrea Riley | General Practice | 781 Palmer Rd Apt 3a, Bronxville, NY 10708-3309 | 2020-02-12 |
| 1104463652 | Ohad Shimshon Bentur | General Practice | 450 E 63rd St Apt 3g, New York, NY 10065-7957 | 2019-12-03 |
| 1285278291 | Echo Clinical Associates LLC | General Practice | 56 Echo Ave., Ste 1, Miller Place, NY 11764-2454 | 2019-11-01 |
| 1710528583 | Debra Heverly | General Practice | 2315 Whirlpool St # 415, Niagara Falls, NY 14305-2413 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.