Paul Phillip Bergeron, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

154468 Issued in MA

Practice address

2 Northdale Ter
Boston, MA 02132-5514

Phone

(603) 459-4522

NPI assigned

Sep 6, 2005

Last updated

Jan 23, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Skilled Medical Provider Group PLLC

  • Internal Medicine Physician
  • Durham, NH
  • NPI 1386952844
  Authorized official Same address or phone
• Family Whole Health PLLC

  • Pediatrics Physician
  • Boston, MA
  • NPI 1376387274
  NPD
• Sherrill House, Inc

  • Skilled Nursing Facility
  • Boston, MA
  • NPI 1356496947
  NPD (past)
• Appledore Medical Group, Inc

  • Internal Medicine Physician
  • Portsmouth, NH
  • NPI 1720077167
  NPD (past)
• Movn Health Medical Group PC

  • Cardiovascular Disease Physician
  • Los Angeles, CA
  • NPI 1588441612
  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1316931355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 NORTHDALE TER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021325514",
            "telephone_number": "603-459-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 NORTHDALE TER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021325514",
            "telephone_number": "603-459-4522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Surrey Ln",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NH",
            "postal_code": "038244413",
            "country_code": "US",
            "telephone_number": "603-659-0330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "PAUL",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "154468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamar Rebecca Berger, M.D., PH.D.
• Emilie Bergeron, M.D.
• Laurie J Bergeron
• Marcy Bergeron, NP
• Meghan Kathleen Bergeron, ARNP
• Lisa Bergersen, MD MPH
• Peter Roald Bergethon, M.D.
• Ann Marie Bergin, MD
• Elise Bergin, MS, CGC
• Isabella Sofia Berglund-Brown, MD MPH

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.