Individual provider Active NPI

Ronald Lee Bergman, PH.D

  • Clinical Psychologist
  • Miami, FL
National Provider Identifier
1013980788
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2048 Issued in FL
Practice address
2627 NE 203Rd St
S-214
Miami, FL 33180-1900
Phone
(305) 932-3666
Fax
(305) 932-3666
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY2048 FL Primary

Addresses

Primary practice location

2627 NE 203Rd St
S-214
Miami, FL 33180-1900

Mailing address

2627 NE 203Rd St
S-214
Miami, FL 33180-1900
Phone (305) 932-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100825000865 FL Practitioner - Clinical Psychologist 3971634544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

300 S Pine Island Rd
Plantation, FL 33324-2620
Phone (954) 382-2288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY2048FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald L. Bergman, PH.D., P.a. Clinical CurrentSince Dec 13, 2009 Accepting new patients

Locations

2627 NE 203rd St
#S214
Miami, FL 33180
Phone (305) 932-3666

2627 NE 203rd St
Ste 214
Miami, FL 33180
Phone (305) 608-6464

300 S Pine Island Rd
Ste 220
Plantation, FL 33324
Phone (954) 243-3424

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1013980788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 NE 203RD ST",
            "address_2": "S-214",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331801900",
            "telephone_number": "305-932-3666",
            "fax_number": "305-932-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 NE 203RD ST",
            "address_2": "S-214",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331801900",
            "telephone_number": "305-932-3666",
            "fax_number": "305-932-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "RONALD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.