Individual provider Active NPI

Richard C Berg Jr., MD

  • Surgery Physician
  • Lafayette, IN
National Provider Identifier
1124097977
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01056973A Issued in IN
Practice address
2600 Greenbush St
Lafayette, IN 47904-2479
Phone
(765) 448-8000
Fax
(765) 448-8027
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01056973A IN Primary

Addresses

Primary practice location

2600 Greenbush St
Lafayette, IN 47904-2479

Mailing address

1200 W White River Blvd
Muncie, IN 47303-4988
Phone (877) 668-5621

Other identifiers 5

IdentifierTypeStateIssuer
10923010OtherINCAQH NUMBER
200402790MedicaidIN
000000248484OtherINANTHEM PROVIDER NUMBER
467264OtherINPHCS PID NUMBER
G34750OtherINMEDICARE UPIN NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bergr@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050204000157 IN Practitioner - General Surgery 1759295058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Pennsylvania State University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2600 Ferry St
Lafayette, IN 47904-3055
Phone (765) 448-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)13
Mastectomy24
Melanoma (skin cancer) excision15
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056973AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Current Accepting new patients
Arnett Clinic, LLC Surgery CurrentSince Jan 13, 2005 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Arnett Clinic, LLC CurrentSince Jan 13, 2005 Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

1300 S Jackson St
Frankfort, IN 46041
Phone (765) 656-3000

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2600 Greenbush St
Lafayette, IN 47904

1500 Salem St
Lafayette, IN 47904
Phone (765) 420-1400

2600 Ferry St
Lafayette, IN 47904

5177 McCarty Ln
Lafayette, IN 47905
Phone (765) 838-7101

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

420 N 26th St
Lafayette, IN 47904
Phone (765) 448-7500

720 S 6th St
Monticello, IN 47960
Phone (574) 583-1776

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

1104 E Grace St
Rensselaer, IN 47978
Phone (219) 866-2026

253 Sagamore Pkwy W
West Lafayette, IN 47906

Interoperability endpoints

  • Direct secure messaging: bergr@direct.iuhealth.org

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 4

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1124097977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042479",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01056973A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "10923010",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200402790",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000248484",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PID NUMBER",
            "identifier": "467264",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN NUMBER",
            "identifier": "G34750",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bergr@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479042479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.