Jeremy Dean Berg, MD

Primary specialty

Forensic Pathology PhysicianTaxonomy code 207ZF0201X

License

32760 Issued in NE

Practice address

4840 F St
Omaha, NE 68117-1407

Phone

(402) 731-4145

Fax

(402) 731-8653

NPI assigned

Apr 23, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Physicians Laboratory Services, Inc

  • Clinical Medical Laboratory
  • Omaha, NE
  • NPI 1396833026
  NPD (past)
• Physicians Laboratory, PC

  • Clinical Medical Laboratory
  • Omaha, NE
  • NPI 1306929617
  NPD (past)

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1194112581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 F ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681171407",
            "telephone_number": "402-731-4145",
            "fax_number": "402-731-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 F ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681171407",
            "telephone_number": "402-731-4145",
            "fax_number": "402-731-8653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11001 Cedar Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441063022",
            "country_code": "US",
            "telephone_number": "216-721-5610",
            "fax_number": "216-721-2559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "JEREMY",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35.136417",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SD",
            "license": "221",
            "primary": false
        },
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "NE",
            "license": "32760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Berg
• Bethany Berg
• David Carl Berg
• Heather Marie Berg, RN
• Ingrid H Berg, DO
• Kendall Berg
• Samuel Wesley Berg, MD
• Sydney L Berg, PA-C
• Teresa G Berg, MD
• Bergan Mercy Surgery Center, LLC

• Forensic Pathology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Forensic Pathology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.