Active NPI
Daniel Joseph Bergmann, MD
- Surgery Physician
- St Peters, MO
National Provider Identifier
1548238751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 36151
- Practice address
- 6 Jungermann Circle
Ste 205
St Peters, MO 63376 - Phone
- (636) 441-2122
- Fax
- (636) 441-5290
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 36151 | MO | Primary |
Addresses
Primary practice location
6 Jungermann Circle
Ste 205
St Peters, MO 63376
Mailing address
6 Jungermann Circle
Ste 205
St Peters, MO 63376
Phone (636) 441-2122
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25582 | Other | BLUE CROSS BLUE SHIELD | |
| 3086713001SP11526 | Other | SIGNA | |
| 11637 | Other | ESSENCE | |
| 201292216BE | Medicaid | MO | |
| 088442 | Other | GREAT WEST | |
| 4061300 | Other | AETNA | |
| G038 | Other | PRINCIPAL | |
| STL1700065 | Other | UNITED HEALTHCARE | |
| 100010 | Other | HEALTHLINK | |
| 3554V2907 | Other | GHP | |
| 430910980005 | Other | PRUDENTIAL | |
| 1016224 | Other | CARE PARTNERS | |
| 017022 | Other | EXLCUSIVE CHOICE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1548238751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 JUNGERMANN CIRCLE",
"address_2": "STE 205",
"city": "ST PETERS",
"state": "MO",
"postal_code": "63376",
"telephone_number": "636-441-2122",
"fax_number": "636-441-5290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 JUNGERMANN CIRCLE",
"address_2": "STE 205",
"city": "ST PETERS",
"state": "MO",
"postal_code": "63376",
"telephone_number": "636-441-2122",
"fax_number": "636-441-5290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMANN",
"first_name": "DANIEL",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "36151",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "25582",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIGNA",
"identifier": "3086713001SP11526",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ESSENCE",
"identifier": "11637",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201292216BE",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "088442",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4061300",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRINCIPAL",
"identifier": "G038",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "STL1700065",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "100010",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "3554V2907",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRUDENTIAL",
"identifier": "430910980005",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE PARTNERS",
"identifier": "1016224",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXLCUSIVE CHOICE",
"identifier": "017022",
"state": null
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "6 Jungermann Circle",
"address_2": "Ste 205",
"city": "St Peters",
"state": "MO",
"country_code": "US",
"postal_code": "63376",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in St Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.