Gerald J Bergman DPM PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N0018861 Issued in NY

Legal business name

GERALD J BERGMAN DPM PC

Practice address

1400 Wantagh Ave
Suite 202
Wantagh, NY 11793-2210

Phone

(516) 781-1943

Fax

(516) 781-1943

NPI assigned

Oct 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gerlad J Bergman, DPM

Title

Podiatrist

Phone

(516) 781-1943

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578644308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WANTAGH AVE",
            "address_2": "SUITE 202",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932210",
            "telephone_number": "516-781-1943",
            "fax_number": "516-781-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WANTAGH AVE",
            "address_2": "SUITE 202",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932210",
            "telephone_number": "516-781-1943",
            "fax_number": "516-781-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD J BERGMAN DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "GERLAD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "516-781-1943",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N0018861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0030766",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00401538",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2890117",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.