CMS-1500 Box 24J / 33a • NPI
1114260007
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
208000000X (CMS 37)
Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)
Box 32 Service Location & ZIP+4
10775 PIONEER TRL STE 215, TRUCKEE, CA, 96161-0234
✓ 9-Digit EDI 837 ZIP+4 (96161-0234)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1114260007 (JENNIFER BERKOVICH, D.O.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1114260007 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JENNIFER BERKOVICH, D.O. |
| Plain-English Specialty | Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: 208000000X (Pediatrics) |
| Certifying / Licensing Body | American Board of Pediatrics (ABP) |
| Practice Location Address | 10775 PIONEER TRL STE 215, TRUCKEE, CA, 96161-0234 |
| Practice Telephone / Fax | Tel: (415) 424-4266 | Fax: (415) 520-6633 |
| Administrative Mailing Address | 8300 ESTERS BLVD STE 900, IRVING, TX, 75063-2233 |
| Enumeration & Last Sync | Enumerated: 2013-03-29 | CMS Record Updated: 2024-07-24 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (208000000X)
What Does Taxonomy Code 208000000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208000000X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JENNIFER BERKOVICH, D.O.)
Typical CPT / Diagnostic Procedures:- Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
- Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
- Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
- Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
- Pediatric Asthma Nebulization & Spirometry Evaluation
- Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
- WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
- Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
- Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: NY | License: 316856 | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: IL | License: 036146456 | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: TX | License: T2829 | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: NJ | License: 25MB11532000 | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: FL | License: OS13916 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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