Individual provider Active NPI

Roseanne Berger, MD

  • Family Medicine Physician
  • Williamsville, NY
National Provider Identifier
1184617706
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
137169 Issued in NY
Practice address
850 Hopkins Rd
Williamsville, NY 14221-1729
Phone
(716) 688-9641
Fax
(716) 829-2447
NPI assigned
Aug 30, 2005
Last updated
Jun 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 137169 NY Primary

Addresses

Primary practice location

850 Hopkins Rd
Williamsville, NY 14221-1729

Mailing address

850 Hopkins Rd
Williamsville, NY 14221-1729
Phone (716) 688-9641

Other identifiers 1

IdentifierTypeStateIssuer
00790189MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20081219000121 NY Practitioner - Family Practice 8022170463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ub Family Medicine IncGroup PAC ID 1658361381, 37 clinicians

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 831-8612

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Family Medicine CurrentSince Oct 1, 2000 Accepting new patients
University Emergency Medical Services Inc. Current Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

462 Grider St
Fl 9
Buffalo, NY 14215
Phone (716) 898-3198

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

850 Hopkins Rd
Williamsville, NY 14221
Phone (716) 639-8358

Interoperability endpoints

  • Direct secure messaging: roseanneberger@ubmd.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1184617706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HOPKINS RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211729",
            "telephone_number": "716-688-9641",
            "fax_number": "716-829-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HOPKINS RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211729",
            "telephone_number": "716-688-9641",
            "fax_number": "716-829-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "ROSEANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "137169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00790189",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.