Active NPI
Mathieu Bergeron, M.D
- Pediatric Otolaryngology Physician
- Cincinnati, OH
National Provider Identifier
1356794861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Otolaryngology Physician
- License
- 57.028645
- Practice address
- 105 W 4TH St
Apt 703
Cincinnati, OH 45202-2712 - Phone
- (513) 497-6664
- NPI assigned
- Jul 20, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Otolaryngology Physician | 207YP0228X | 57.028645 | OH | Primary |
Addresses
Primary practice location
105 W 4TH St
Apt 703
Cincinnati, OH 45202-2712
Mailing address
105 W 4TH St
Apt 703
Cincinnati, OH 45202-2712
Phone (513) 497-6664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.028645 | OH | MD | Pediatric Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1356794861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 W 4TH ST",
"address_2": "APT 703",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452022712",
"telephone_number": "513-497-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 W 4TH ST",
"address_2": "APT 703",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452022712",
"telephone_number": "513-497-6664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGERON",
"first_name": "MATHIEU",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-20",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "OH",
"license": "57.028645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.