NPIMap

Organization Active NPI

Matthew a Berger MD PC

  • Physician Assistant
  • Moosic, PA
National Provider Identifier
1275617508
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
MATTHEW A BERGER MD PC
Practice address
340 Montage Mountain Rd
Moosic, PA 18507-1782
Phone
(570) 346-3686
NPI assigned
Oct 24, 2006
Last updated
Jul 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Dr. Matthew A. Berger, MDNPI 1295718237
Title
Sole Practitioner
Phone
(570) 346-3686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Psychiatry Physician 2084P0800X MD01016L PA

Addresses

Primary practice location

340 Montage Mountain Rd
Moosic, PA 18507-1782

Mailing address

340 Montage Mountain Rd
Moosic, PA 18507-1782
Phone (570) 346-3686

Other identifiers 1

IdentifierTypeStateIssuer
0011429780004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000697 PA Part B Supplier - Clinic/Group Practice 5991791212 Receives reassigned benefits from 61 practitioners
Practice locations: Kingston, PA; Moosic, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1275617508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071782",
            "telephone_number": "570-346-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071782",
            "telephone_number": "570-346-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW A BERGER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SOLE PRACTITIONER",
        "authorized_official_telephone_number": "570-346-3686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD01016L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011429780004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moosic, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.