Organization Active NPI

Michael L Berger OD PC

  • Optometrist
  • Glendale, AZ
National Provider Identifier
1033388699
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AZ0340 Issued in AZ
Legal business name
MICHAEL L BERGER OD PC
Practice address
6677 W Thunderbird Rd #B132
Glendale, AZ 85306-3713
Phone
(602) 978-1199
NPI assigned
Feb 27, 2008
Last updated
Mar 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Carol A. Miller
Title
Optician
Phone
(602) 978-1199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AZ0340 AZ Primary

Addresses

Primary practice location

6677 W Thunderbird Rd #B132
Glendale, AZ 85306-3713

Mailing address

6677 W Thunderbird Rd # B132
Glendale, AZ 85306-3713
Phone (602) 978-1199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040614000884 AZ Part B Supplier - Clinic/Group Practice 8729062211 Receives reassigned benefits from 2 practitioners
Practice locations: Glendale, AZ

National Provider Directory

National Provider Directory

Locations

4920 W Thunderbird Rd
Ste 122
Glendale, AZ 85306
Phone (602) 978-1199

6677 W Thunderbird Rd
Ste B132
Glendale, AZ 85306
Phone (602) 978-1199

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1033388699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD # B132",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063713",
            "telephone_number": "602-978-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD #B132",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063713",
            "telephone_number": "602-978-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L BERGER OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "602-978-1199"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ0340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.