Robert Todd Bergman, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12009216 Issued in IN

Practice address

2350 Northpark
Columbus, IN 47203

Phone

(812) 372-7312

Fax

(812) 378-9451

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rbergman11576@edirect.crh.org

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.

• Columbus Oral & Maxillofacial Surgery PSC

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbus, IN
  • NPI 1629134515
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1497811301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 NORTHPARK",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "47203",
            "telephone_number": "812-372-7312",
            "fax_number": "812-378-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 NORTHPARK",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "47203",
            "telephone_number": "812-372-7312",
            "fax_number": "812-378-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "ROBERT",
        "middle_name": "TODD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12009216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000251000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Gordon Bennett, MD
• Brittani N. Benoit, PT,DPT
• Brooke Bense, DPT
• Mary Benson, LMT
• Linda Benter
• Xabier Beristain, MD
• Shivani Mahesh Bhave
• Bhi Senior Living, Inc.
• Ashwini Sudhir Bhise, PH.D., IBCLC
• Bailey Bickel, RBT

• Oral and Maxillofacial Surgery (Dentist) in Columbus, IN
• Providers in Columbus, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.