NPIMap

Individual provider Active NPI

Samuel Clark Berngard, M.D.

  • Pulmonary Disease Physician
  • Boulder, CO
National Provider Identifier
1265708622
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
DR.0053721 Issued in CO
Practice address
4820 Riverbend Rd Ste 100
Boulder, CO 80301-2618
Phone
(303) 415-5399
Fax
(303) 297-5808
NPI assigned
Mar 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X DR.0053721 CO Primary

Addresses

Primary practice location

4820 Riverbend Rd Ste 100
Boulder, CO 80301-2618

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-5399

Other practice location 1

90 Health Park Dr Ste 130
Louisville, CO 80027-9586
Phone (303) 415-5399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160824000986 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 1759516255 Reassigns benefits to 1 organization
I20180820002670 CO Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 1759516255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Colorado School of Medicine, Denver, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

1000 W S Boulder Rd
Lafayette, CO 80026-2089

1755 48TH St
Suite 200
Boulder, CO 80301-2712
Phone (303) 415-7450

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7610

4820 Riverbend Rd
Suite 100
Boulder, CO 80301-2618
Phone (303) 415-5399

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Jul 4, 2016 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Boulder Community Health CurrentSince Sep 28, 2018 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Sep 28, 2018 Accepting new patients
Scripps Health Current Accepting new patients
KND Development 59 LLC CurrentSince Jul 4, 2016 Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

4940 El Cajon Blvd
San Diego, CA 92115
Phone (619) 543-4500

4743 Arapahoe Ave
Ste 201C
Boulder, CO 80303
Phone (303) 442-2150

4743 Arapahoe Ave
Boulder, CO 80303
Phone (303) 444-9000

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

4820 Riverbend Rd
Ste 100
Boulder, CO 80301
Phone (303) 415-5399

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

101 Erie Pkwy
Erie, CO 80516
Phone (303) 415-5170

90 Health Park Dr
Ste 130
Louisville, CO 80027
Phone (303) 415-5399

Interoperability endpoints

  • Direct secure messaging: sberngard34352@scrippshlth.medalliesdirect.net

Organizations & group practices 8

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1265708622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-5399",
            "fax_number": "303-297-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 RIVERBEND RD STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012618",
            "telephone_number": "303-415-5399",
            "fax_number": "303-297-5808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Health Park Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800279586",
            "country_code": "US",
            "telephone_number": "303-415-5399",
            "fax_number": "303-297-5808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNGARD",
        "first_name": "SAMUEL",
        "middle_name": "CLARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CO",
            "license": "DR.0053721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.