Individual provider Active NPI

Paul Allen Bergfelder, MD

  • Internal Medicine Physician
  • Richmond, IN
National Provider Identifier
1508872938
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01030885A Issued in IN
Practice address
1915 Chester Blvd
Richmond, IN 47374-1212
Phone
(765) 935-2567
Fax
(765) 962-0880
NPI assigned
Jul 31, 2006
Last updated
Nov 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01030885A IN Primary

Addresses

Primary practice location

1915 Chester Blvd
Richmond, IN 47374-1212

Mailing address

1915 Chester Blvd
Richmond, IN 47374-1212
Phone (765) 935-2567

Other identifiers 1

IdentifierTypeStateIssuer
100256490CMedicaidIN

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000418 IN Practitioner - Internal Medicine 2567638141

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Reid Hospital & Health Care Services, Inc Past Accepting new patients
Reid Hospital & Health Care Services Inc Internal Medicine 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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1508872938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 CHESTER BLVD",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741212",
            "telephone_number": "765-935-2567",
            "fax_number": "765-962-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 CHESTER BLVD",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741212",
            "telephone_number": "765-935-2567",
            "fax_number": "765-962-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGFELDER",
        "first_name": "PAUL",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01030885A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100256490C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.