Kevin Matthew Berger, L.AC., DIPL. O.M.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

KO000627 Issued in PA

Practice address

121 N Reading Ave
Boyertown, PA 19512-1011

Phone

(610) 367-1633

NPI assigned

Dec 15, 2009

Last updated

Nov 8, 2022By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

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  • NPI 1780392878
  NPD Authorized official

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1356670632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N READING AVE",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "19512",
            "telephone_number": "610-367-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N READING AVE",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "195121011",
            "telephone_number": "610-367-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "L.AC., DIPL. O.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-15",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "KO000627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Boyertown, PA
• Providers in Boyertown, PA by specialty
• General Practice Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.