Martin Jan Bergman

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD 030099E Issued in PA

Legal business name

MARTIN JAN BERGMAN

Practice address

23 W Chester Pike
Suite 201
Ridley Park, PA 19078-1629

Phone

(610) 521-1701

Fax

(610) 521-9450

NPI assigned

Dec 15, 2014

Last updated

Jul 16, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Martin Jan Bergman, MDNPI 1710977004

Title

Owner

Phone

(610) 521-1701

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Martin Jan Bergman, M.D.

  • Rheumatology Physician
  • Ridley Park, PA
  • NPI 1710977004
  NPD (past) Authorized official
• Amy Lee Lundholm, D.O.

  • Rheumatology Physician
  • Ridley Park, PA
  • NPI 1689901324
  NPD (past)

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1467850941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 W CHESTER PIKE",
            "address_2": "SUITE 201",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190781629",
            "telephone_number": "610-521-1701",
            "fax_number": "610-521-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 W CHESTER PIKE",
            "address_2": "SUITE 201",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190781629",
            "telephone_number": "610-521-1701",
            "fax_number": "610-521-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN JAN BERGMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-15",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-521-1701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD 030099E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "043725",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010798830002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily & Rose Home Care
• Milly H Long, MD
• Amy Lee Lundholm, D.O.
• Jeffrey Malumed, M.D.
• Jessica Manzi, LCSW
• Shannon K McClurkin, CRNA
• Andrea Saxon McGuinness, M.D.
• Armando A Mendez, M.D.
• Caitlin C Moore, PA-C
• Stephanie Mostone, DNP, FNP-BC

• Rheumatology Physician in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Rheumatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.