Daniel Ralph Berg, MD
Individual provider Active NPI Internal Medicine Physician · Saint Louis, MO
NPI 1013947555 · NPPES record last updated Jan 18, 2022
Key facts
- NPI
- 1013947555
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2002001981 (MO)
- Practice address
- 401 Holly Hills Ave
Saint Louis, MO 63111-2410 - Phone
- (314) 353-5190
- Fax
- (314) 353-7631
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Washington University School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- County of St Louis Division of Fiscal Management
SSM Health Care St Louis
Practice addresses (Care Compare)
6121 N Hanley Rd
Saint Louis, MO 63134-2003
Phone (314) 615-0560
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8000
Hospital & facility affiliations
- SSM Health St Mary'S Hospital - St Louis
- Christian Hospital Northeast
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070503000255 | MO | Practitioner - Internal Medicine | 1759285257 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002001981 | MO | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington University | Current |
Accepting new patients | |
| County of St Louis Division of Fiscal Management | Current |
Accepting new patients | |
| Washington University | Current |
Accepting new patients | |
| SSM Health Care St. Louis | Internal Medicine | Current |
Accepting new patients |
| County of St Louis Division of Fiscal Management | Current |
Accepting new patients | |
| SSM Health Care St Louis | Current |
Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
8 Millstone Campus Dr
Saint Louis, MO 63146
Phone (314) 273-4375
1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170
6121 N Hanley Rd
#C
Saint Louis, MO 63134
Phone (314) 615-0500
4580 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 615-0400
6121 N Hanley Rd
Saint Louis, MO 63134
Phone (314) 522-6410
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
Interoperability endpoints
- dberg6296@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2002001981 | MO | Yes |
| Hospitalist Physician | 208M00000X | 2002001981 | MO |
Addresses
Primary practice location
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Mailing address
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone (314) 353-5190
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202846804 | Medicaid | MO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) | Barnes Jewish Hospital |
Other providers in Saint Louis, MO
- Carolyn A Bequette
- Gregg Jonathan Berdy
- Stephanie Ann Berdy
- Susan S Berdy
- Caleb James Berg
- Katelyn Adrianna Berg
- Madison Nicole Berg
- Mark S Berg
- Melissa Renee Berg
- Sarah Elizabeth Berg
All providers in Saint Louis, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.