Individual provider Active NPI

Anthony Peter Berger, MD

  • Dermatology Physician
  • Holland, MI
National Provider Identifier
1508391160
Registry record updated Aug 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01086101A Issued in IN
Practice address
1148 Washington Ave Ste 20
Holland, MI 49423-7728
Phone
(616) 499-4844
Fax
(616) 499-4847
NPI assigned
Apr 20, 2017
Last updated
Aug 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01086101A IN Primary

Addresses

Primary practice location

1148 Washington Ave Ste 20
Holland, MI 49423-7728

Mailing address

1148 Washington Ave Ste 20
Holland, MI 49423-7728
Phone (616) 499-4844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210830002326 MI Practitioner - Dermatology 1759652332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Iowa, RJ & L Carver College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1148 Washington Ave
Suite 20
Holland, MI 49423-7728
Phone (616) 499-4844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision21
Removal of skin lesions479
Removal of skin cancer43
Skin biopsy147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6803WIMDSocial Worker
01086101AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Michigan Dermatology PLLC Dermatology CurrentSince Apr 1, 2022 Accepting new patients

Locations

1148 Washington Ave
Ste 20
Holland, MI 49423
Phone (616) 499-4844

Interoperability endpoints

  • Direct secure messaging: aberger@lmd.emadirect.md

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659830400000",
    "number": "1508391160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 WASHINGTON AVE STE 20",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237728",
            "telephone_number": "616-499-4844",
            "fax_number": "616-499-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 WASHINGTON AVE STE 20",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237728",
            "telephone_number": "616-499-4844",
            "fax_number": "616-499-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "ANTHONY",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2022-08-07",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01086101A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.