Individual provider Active NPI

Shari Alissa Berg, DO

  • Family Medicine Physician
  • Largo, FL
National Provider Identifier
1538166269
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS8908 Issued in FL
Practice address
11200 Seminole Blvd Ste 210
Largo, FL 33778-3239
Phone
(727) 319-8900
NPI assigned
Jul 7, 2005
Last updated
Dec 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS8908 FL Primary

Addresses

Primary practice location

11200 Seminole Blvd Ste 210
Largo, FL 33778-3239

Mailing address

11200 Seminole Blvd Ste 210
Largo, FL 33778-3239
Phone (727) 319-8900

Other identifiers 3

IdentifierTypeStateIssuer
267469600MedicaidFL
P00922489OtherFLMEDICARE RAILROAD PROVIDER NUMBER
PN929OtherFLMCR PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20081222000445 FL Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Family Practice 5496817645 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice, General Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

11200 Seminole Blvd
Suite 210
Largo, FL 33778-3239
Phone (727) 319-8900

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Feb 1, 2026 Accepting new patients
Verimed Health Group Seminole, LLC CurrentSince Apr 1, 2023 Accepting new patients
Best Value Healthcare LLC CurrentSince Aug 1, 2022 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Feb 1, 2026 Accepting new patients
Sunset Point Medical Associates Inc Family Medicine Past Accepting new patients
Americare Physicians Group, LLC Past Accepting new patients
St Anthony's Primary Care LLC Family Medicine Past Accepting new patients

Locations

1100 S Fort Harrison Ave
Clearwater, FL 33756
Phone (727) 442-3126

1305 S Fort Harrison Ave
Ste C
Clearwater, FL 33756
Phone (727) 483-9188

2128 Main St
Dunedin, FL 34698
Phone (727) 736-7733

3800 E Bay Dr
Largo, FL 33771
Phone (727) 539-0505

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

11200 Seminole Blvd
Ste 210
Seminole, FL 33778
Phone (727) 319-8900

12450 Roosevelt Blvd N
Ste 308
St Petersburg, FL 33716
Phone (727) 572-0900

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 8

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1538166269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 SEMINOLE BLVD STE 210",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337783239",
            "telephone_number": "727-319-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 SEMINOLE BLVD STE 210",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337783239",
            "telephone_number": "727-319-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "SHARI",
        "middle_name": "ALISSA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267469600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "P00922489",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR PTAN",
            "identifier": "PN929",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.