Individual provider Active NPI

Jeremy Alex Berger, OD

  • Optometrist
  • Glendale, AZ
National Provider Identifier
1306685938
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002802 Issued in AZ
Practice address
6677 W Thunderbird Rd Ste B132
Glendale, AZ 85306-3713
Phone
(602) 978-1199
NPI assigned
May 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002802 AZ Primary

Addresses

Primary practice location

6677 W Thunderbird Rd Ste B132
Glendale, AZ 85306-3713

Mailing address

19800 N 7TH St Apt 3064
Phoenix, AZ 85024-1894
Phone (602) 459-0978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240816000832 AZ Practitioner - Optometry 6901344308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael L. Berger OD, PCGroup PAC ID 8729062211, 2 clinicians

Practice addresses (Care Compare)

6677 W Thunderbird Rd
Suite B132
Glendale, AZ 85306-3713
Phone (602) 978-1199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L Berger OD PC Optometrist CurrentSince Jul 16, 2024 Accepting new patients

Locations

6677 W Thunderbird Rd
Ste B132
Glendale, AZ 85306
Phone (602) 978-1199

4920 W Thunderbird Rd
Ste 122
Glendale, AZ 85306
Phone (602) 978-1199

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1306685938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19800 N 7TH ST APT 3064",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241894",
            "telephone_number": "602-459-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD STE B132",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063713",
            "telephone_number": "602-978-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "JEREMY",
        "middle_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.