Active NPI
Donald M Bergner, M.D.
- Urology Physician
- Safety Harbor, FL
National Provider Identifier
1396738407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME0030517
- Practice address
- 1840 Mease Drive
Suite 300
Safety Harbor, FL 34695 - Phone
- (727) 785-6011
- Fax
- (727) 787-6951
- NPI assigned
- Aug 24, 2005
- Last updated
- Aug 25, 2011
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME0030517 | FL | Primary |
Addresses
Primary practice location
1840 Mease Drive
Suite 300
Safety Harbor, FL 34695
Mailing address
1840 Mease Dr
Suite 300
Safety Harbor, FL 34695
Phone (727) 785-6011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 065654200 | Medicaid | FL |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0030517 | FL | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Specialists in Urology, P.a. | Past | Accepting new patients | |
| Urology Consultants, Inc. | Past | Accepting new patients | |
| Advanced Urology Institute, LLC | Urology | Past | Accepting new patients |
| Advanced Urology Institute, LLC | Urology | Past | Accepting new patients |
Organizations & group practices 4
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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Urology
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314230400000",
"number": "1396738407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 MEASE DR",
"address_2": "SUITE 300",
"city": "SAFETY HARBOR",
"state": "FL",
"postal_code": "34695",
"telephone_number": "727-785-6011",
"fax_number": "727-787-6951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 MEASE DRIVE",
"address_2": "SUITE 300",
"city": "SAFETY HARBOR",
"state": "FL",
"postal_code": "34695",
"telephone_number": "727-785-6011",
"fax_number": "727-787-6951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGNER",
"first_name": "DONALD",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2011-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME0030517",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "065654200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Safety Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.