| Solomon I Berkowitz, CAA | |
|
151 Pennsylvania Pkwy, Carmel, IN 46280-1379 | |
| (317) 577-4200 | |
| (317) 577-4200 |
| Full Name | Solomon I Berkowitz |
|---|---|
| Gender | Male |
| Speciality | Anesthesiologist Assistant |
| Location | 151 Pennsylvania Pkwy, Carmel, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396978540 | NPI | - | NPPES |
| 1100145426 | Other | IN | ANTHEM PTAN |
| 300097010 | Medicaid | IN | |
| Q00773302 | Other | IN | RAILROAD PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 1911 (Georgia) | Secondary |
| 367H00000X | Anesthesiologist Assistant | 75000147A (Indiana) | Primary |
| Entity Name | Georgia Group Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093947236 PECOS PAC ID: 0840338018 Enrollment ID: O20091109000203 |
| Entity Name | Grady Memorial Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114243813 PECOS PAC ID: 7517032998 Enrollment ID: O20100723000311 |
| Entity Name | Mak Anesthesia Northside Affiliates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609390103 PECOS PAC ID: 7315203718 Enrollment ID: O20171116002499 |
| Mailing Address | Practice Location Address |
|---|---|
| Solomon I Berkowitz, CAA 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Solomon I Berkowitz, CAA 151 Pennsylvania Pkwy, Carmel, IN 46280-1379 Ph: (317) 577-4200 |
Jonathon R Roullard, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 11700 N Meridian St, Carmel, IN 46032 Phone: 317-577-4200 | |
Margaret Hajje, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 151 Pennsylvania Pkwy, Carmel, IN 46280 Phone: 317-577-4200 Fax: 317-577-4200 | |
Brandon Matthew Haynes, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 10300 N Illinois St, Carmel, IN 46290 Phone: 317-817-8080 | |
Michael E Ferrante, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 11700 N Meridian St, Carmel, IN 46032 Phone: 317-577-4200 |