Fred Jay Berge, MD
Individual provider Active NPI Psychiatry Physician · Santa Barbara, CA
NPI 1205950623 · NPPES record last updated Jun 22, 2015
Key facts
- NPI
- 1205950623
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- G83911 (CA)
- Practice address
- 300 N San Antonio Rd
Building 3, Suite 215
Santa Barbara, CA 93110-1316 - Phone
- (805) 681-5220
- Fax
- (805) 681-5262
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of Vermont College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Santa Barbara County Auditor
Practice addresses (Care Compare)
4444 Calle Real
Santa Barbara, CA 93110-1002
Phone (805) 681-5190
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050307000267 | CA | Practitioner - Psychiatry | 4183678741 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Barbara County County Auditor | Current |
Accepting new patients |
Locations
300 N San Antonio Rd
Bldg 3
Santa Barbara, CA 93110
Phone (805) 681-5440
4444 Calle Real
Santa Barbara, CA 93110
Phone (805) 681-5190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G83911 | CA | Yes |
Addresses
Primary practice location
300 N San Antonio Rd
Building 3, Suite 215
Santa Barbara, CA 93110-1316
Mailing address
300 N San Antonio Rd
Building 3, Suite 215
Santa Barbara, CA 93110-1316
Phone (805) 681-5220
NPI Registry JSON
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434931200000",
"number": "1205950623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N SAN ANTONIO RD",
"address_2": "BUILDING 3, SUITE 215",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931101316",
"telephone_number": "805-681-5220",
"fax_number": "805-681-5262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N SAN ANTONIO RD",
"address_2": "BUILDING 3, SUITE 215",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931101316",
"telephone_number": "805-681-5220",
"fax_number": "805-681-5262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGE",
"first_name": "FRED",
"middle_name": "JAY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2015-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G83911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
- James Maguire Benzian
- Lurleen M Benzian
- Jacqueline Beraldo
- Juliet Dollres White Berardinelli
- Jack Bergal
- Angelika Marion Berger
- Daniel Nathan Berger
- Kelly James Berger
- Mica Yael Bergman
- Charles Alan Bergquist
All providers in Santa Barbara, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.