Brian Berg

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS022091 Issued in PA

Practice address

3401 N Broad St
Philadelphia, PA 19140-5103

Phone

(215) 707-5030

Fax

(215) 707-3494

NPI assigned

May 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT, OR2 enrollments

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 2

Specialty

Emergency Medicine

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - Oregon 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
• Central Montana Medical Center Hospital, Lewistown, MT, CCN 271345

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Health & Services - Oregon

  • Clinic/Center
  • Medford, OR
  • NPI 1093976243

  OR

  Medicare reassignment Care Compare group NPD
• Central Montana Medical Facilities, Inc.

  • Family Medicine Physician
  • Lewistown, MT
  • NPI 1497868814

  MT

  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Rehabilitation Hospital Unit
  • Medford, OR
  • NPI 1508949884
  Care Compare group
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare group
• Central Montana Medical Facilities, Inc.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Lewistown, MT
  • NPI 1427161843
  NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Medford, OR
  • NPI 1285185942

  Emergency Medicine

  NPD

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

• Central Montana Medical Facilities, Inc

  • Critical Access Hospital
  • Lewistown, MT
  • NPI 1790798387

  Hospital

  Care Compare affiliation
• Central Montana Medical Facilities, Inc.

  • Land Ambulance
  • Lewistown, MT
  • NPI 1770696601

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1669962841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST RM 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-926-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5030",
            "fax_number": "215-707-3494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "02886",
            "country_code": "US",
            "telephone_number": "401-737-7010 x35664",
            "fax_number": "401-736-1975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "LP04422",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS022091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shivali Berera, M.D.
• Alana L Beres, MD
• Konstantin Berestnev, MD
• Damian R Bereza, BSC, RPH
• Alan P Berg, MD
• David S Berg, PH.D.
• Hanalei Yelensky Berg, LCSW
• Julieann M Berg, DPT
• Katharine M Berg, MSW, LCSW
• Kent Bradley Berg, MD

• All providers in Philadelphia, PA
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.