NATHAN B BERAHA M.D. NPI 1700882529

NPI Information

  • NPI: 1700882529
  • Provider Name: NATHAN B BERAHA, M.D.
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1 COMMERCE ST
    PEDIATRICS
    LINCOLN, RI
    ZIP 02865
  • Phone: (401) 793-8484

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NPI Details

Nathan B Beraha, M.D. is an adolescent medicine pediatrics in Lincoln, RI. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. Nathan B Beraha, M.D. NPI is 1700882529. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1 COMMERCE ST
PEDIATRICS
LINCOLN, RI
ZIP 02865
Phone: (401) 793-8484
Fax: (401) 793-8481

The NPI 1700882529 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/27/2005 and was last updated on 12/7/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0202XPediatricsPediatric CardiologyMD06656RHODE ISLANDNo
22080A0000XPediatricsAdolescent MedicineMD06656RHODE ISLANDYes
32080A0000XPediatricsAdolescent Medicine40994-020WISCONSINNo
42080A0000XPediatricsAdolescent Medicine204275MASSACHUSETTSNo
52080P0202XPediatricsPediatric Cardiology204275MASSACHUSETTSNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12005484MEDICAIDMASSACHUSETTS
27002149MEDICAIDRHODE ISLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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