Boris O Bergus, MD
Individual provider Active NPI Emergency Medicine Physician · East Greenwich, RI
NPI 1013975382 · NPPES record last updated Jul 5, 2022
Key facts
- NPI
- 1013975382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 79021 (MA)
- Practice address
- 1407 S County TRL Ste 431
East Greenwich, RI 02818-1679 - Phone
- (508) 769-2707
- Fax
- (508) 480-8260
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Vincent Physician Services, Inc. | Past |
Accepting new patients | |
| Emergency Medicine Physicians of Providence County, LLC | Emergency Medicine | Past | Accepting new patients |
| Ambulatory Care Physicians at CDH, PC | Emergency Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 79021 | MA | Yes |
Addresses
Primary practice location
1407 S County TRL Ste 431
East Greenwich, RI 02818-1679
Mailing address
1407 S County TRL Ste 431
East Greenwich, RI 02818-1679
Phone (508) 769-2707
Other providers in East Greenwich, RI
- Kristin Ann Benjamin
- Rebecca Lorraine Bennard
- Kayla Jane Benton
- Berghelli Internal Medicine, LLC
- Anthony Berghelli
- Jessica Rachel Berman
- Eric P. Berthiaume
- Raquel Marques Bertolotti
- Sara Elizabeth Bertuccio
- Bethel Behavioral Associates of South County
All providers in East Greenwich, RI · Emergency Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.