Peter Roald Bergethon, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

55896 Issued in MA

Practice address

750 Washington St
Tufts-New England Medical Center #314
Boston, MA 02111-1526

Phone

(617) 636-5848

Fax

(617) 636-8199

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1043265333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRETTON RD",
            "city": "DOVER",
            "state": "MA",
            "postal_code": "020302503",
            "telephone_number": "617-638-4108",
            "fax_number": "617-638-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "address_2": "TUFTS-NEW ENGLAND MEDICAL CENTER #314",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-5848",
            "fax_number": "617-636-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGETHON",
        "first_name": "PETER",
        "middle_name": "ROALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "55896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie J Bergeron
• Marcy Bergeron, NP
• Meghan Kathleen Bergeron, ARNP
• Paul Phillip Bergeron, MD
• Lisa Bergersen, MD MPH
• Ann Marie Bergin, MD
• Elise Bergin, MS, CGC
• Isabella Sofia Berglund-Brown, MD MPH
• Brandon G Bergman, PHD
• Eric D. Bergman, CRNA

• Neurology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.