Michael P Berg, MD

Primary specialty

OptometristTaxonomy code 152W00000X

License

13399 Issued in WA

Practice address

421 West Riverside
#280
Spokane, WA 99201

Phone

(509) 838-2757

Fax

(509) 838-2184

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1013970664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 WEST RIVERSIDE",
            "address_2": "#280",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99201",
            "telephone_number": "509-838-2757",
            "fax_number": "509-838-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 WEST RIVERSIDE",
            "address_2": "#280",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99201",
            "telephone_number": "509-838-2757",
            "fax_number": "509-838-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "13399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1067602",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffery C Berg
• Jill Christie Berg, SLP
• Kayla Berg
• Laura Ann Berg, MSW
• Lauren Alessandra Berg, RN
• Robert Jack Berg
• Matthew Joseph Bergam, MPT
• Anne-Marie C Bergeleen, ARNP
• Sarah Bergen, PMHNP-BD
• Matthew Berger, M.D.

• Optometrist in Spokane, WA
• Providers in Spokane, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.