Active NPI
Michael Bergen, MD
- Vascular & Interventional Radiology Physician
- Cleveland, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 35.146771
- Practice address
- 9500 Euclid Ave
Cleveland, OH 44195-1838 - Phone
- (216) 444-0617
- Fax
- (216) 445-1492
- NPI assigned
- May 21, 2012
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0101267361 | VA | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 0101267361 | VA | |
| General Practice Physician | 208D00000X | 2756654 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | NY | ||
| Vascular & Interventional Radiology Physician | 2085R0204X | 35.146771 | OH | Primary |
Addresses
Primary practice location
9500 Euclid Ave
Cleveland, OH 44195-1838
Mailing address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-6640
Other practice location 1
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | PROSZEM@ccf.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1740 Cleveland Rd
Wooster, OH 44691-2204
Phone (330) 287-4500
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101267361 | VA | MD | Vascular & Interventional Radiology Physician |
| 2756654 | NY | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Cleveland Clinic Foundation | Current | Accepting new patients | |
| Clinic Medical Services Company LLC | Diagnostic Radiology | Current | Accepting new patients |
| Carilion Medical Center | Current | Accepting new patients | |
| Carilion Healthcare Corporation | Current | Accepting new patients | |
| Carilion Giles Community Hospital | Current | Accepting new patients | |
| Carilion Healthcare Corporation | Current | Accepting new patients | |
| Wooster Clinic, LLC | Current | Accepting new patients | |
| Carilion Giles Community Hospital | Current | Accepting new patients | |
| Carilion Rockbridge Community Hospital | Current | Accepting new patients | |
| Clinic Medical Services Company | Diagnostic Radiology | Current | Accepting new patients |
| Carilion Tazewell Community Hospital | Current | Accepting new patients | |
| Carilion Medical Center | Current | Accepting new patients | |
| Carilion Rockbridge Community Hospital | Current | Accepting new patients | |
| Carilion Giles Community Hospital | Current | Accepting new patients |
Locations
2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919
9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270
6100 W Creek Rd
Ste 35
Independence, OH 44131
Phone (212) 986-1666
1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500
1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300
159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000
6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110
1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222
213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353
2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128
388 Ben Bolt Ave
Tazewell, VA 24651
Phone (276) 988-2506
Interoperability endpoints
- proszem@ccf.org
- mbergen119126@direct.carilionclinic.org
Organizations & group practices 14
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1679525919
-
- Multi-Specialty Clinic/Center
- Wooster, OH
- NPI 1033135009
-
- Diagnostic Radiology Physician
- Cleveland, OH
- NPI 1528013984
-
- Critical Access Hospital
- Pearisburg, VA
- NPI 1194718304
-
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1447206370
-
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1730123472
-
- Multi-Specialty Clinic/Center
- Lexington, VA
- NPI 1174636021
-
- General Acute Care Hospital
- Tazewell, VA
- NPI 1427040328
-
- Diagnostic Radiology Physician
- Columbus, OH
- NPI 1508024209
-
- Emergency Medicine Physician
- Pearisburg, VA
- NPI 1164076634
-
- Durable Medical Equipment & Medical Supplies
- Galax, VA
- NPI 1639980493
-
- Durable Medical Equipment & Medical Supplies
- Blacksburg, VA
- NPI 1407667256
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Avon, OH
- NPI 1346607017
-
- General Acute Care Hospital
- Warrensville Heights, OH
- NPI 1235183542
-
- General Acute Care Hospital
- Euclid, OH
- NPI 1598719346
-
- General Acute Care Hospital
- Mayfield HTS, OH
- NPI 1902858152
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1679525919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1407116718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "216-444-6640",
"fax_number": "216-445-1492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441951838",
"telephone_number": "216-444-0617",
"fax_number": "216-445-1492"
}
],
"practiceLocations": [
{
"address_1": "1906 Belleview Ave SE",
"address_purpose": "LOCATION",
"city": "Roanoke",
"state": "VA",
"postal_code": "240141838",
"country_code": "US",
"telephone_number": "540-981-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERGEN",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-21",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VA",
"license": "0101267361",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "VA",
"license": "0101267361",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "2756654",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "OH",
"license": "35.146771",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "PROSZEM@ccf.org",
"affiliation": "N",
"endpointDescription": "business email",
"address_1": "9500 Euclid Ave",
"city": "Cleveland",
"state": "OH",
"country_code": "US",
"postal_code": "441951838",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.