Active NPI
Alpha Berger Journal
- Physician Assistant
- Port St Lucie, FL
National Provider Identifier
1396162889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9107784
- Practice address
- 2115 SE Lennard Rd
Port St Lucie, FL 34952-4742 - Phone
- (772) 335-1812
- Fax
- (772) 335-1825
- NPI assigned
- Mar 24, 2014
- Last updated
- May 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9107784 | FL | Primary |
Addresses
Primary practice location
2115 SE Lennard Rd
Port St Lucie, FL 34952-4742
Mailing address
2115 SE Lennard Rd
Port St Lucie, FL 34952-4742
Phone (772) 335-1812
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Pediatric Medicine | Past | Accepting new patients | |
| Anitha Jagadish M.D, PA | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/e7eee8ee-10a0-491b-8be6-a8be12c18675/
Organizations & group practices 2
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.
-
dba Tender Care Pediatrics
- Pediatrics Physician
- Port Saint Lucie, FL
- NPI 1952538720
-
- Pediatrics Physician
- Danbury, CT
- NPI 1861530750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1396162889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 SE LENNARD RD",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349524742",
"telephone_number": "772-335-1812",
"fax_number": "772-335-1825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 SE LENNARD RD",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349524742",
"telephone_number": "772-335-1812",
"fax_number": "772-335-1825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOURNAL",
"first_name": "ALPHA",
"middle_name": "BERGER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-24",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9107784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.