Individual provider Active NPI

Miro Bergam, M.D.

  • Anesthesiology Physician
  • Livingston, NJ
National Provider Identifier
1104901420
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA06868600 Issued in NJ
Practice address
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone
(973) 322-5512
Fax
(973) 322-8165
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA06868600 NJ Primary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 25MA06868600 NJ

Addresses

Primary practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Mailing address

25B Vreeland Rd
Suite 110
Florham Park, NJ 07932-1900
Phone (973) 660-9334

Other identifiers 1

IdentifierTypeStateIssuer
7919409MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816000031 NJ Practitioner - Anesthesiology 0244260792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Boston University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (732) 369-5994

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06868600NJMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC Anesthesiology CurrentSince Dec 17, 2022 Accepting new patients
Nbimc Department of Cardio-Thoracic CurrentSince Jan 1, 2019 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients
Keystone Group, LLC Anesthesiology Past Accepting new patients

Locations

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

201 Lyons Ave
Ste G5
Newark, NJ 07112
Phone (973) 926-6938

201 Lyons Ave
#L5
Newark, NJ 07112
Phone (973) 926-7161

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1104901420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25B VREELAND RD",
            "address_2": "SUITE 110",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321900",
            "telephone_number": "973-660-9334",
            "fax_number": "973-660-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5512",
            "fax_number": "973-322-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGAM",
        "first_name": "MIRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA06868600",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA06868600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7919409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.