Martin Jan Bergman, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD030099E Issued in PA

Practice address

23 W Chester Pike Ste 201
Ridley Park, PA 19078-1629

Phone

(610) 521-1701

Fax

(610) 521-9450

NPI assigned

Oct 27, 2005

Last updated

Jun 27, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Lee Lundholm, D.O.

  • Rheumatology Physician
  • Ridley Park, PA
  • NPI 1689901324
  Medicare reassignment

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.

• Martin Jan Bergman

  • Rheumatology Physician
  • Ridley Park, PA
  • NPI 1467850941
  NPD (past) Authorized official

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1710977004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 W CHESTER PIKE STE 201",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190781629",
            "telephone_number": "610-521-1701",
            "fax_number": "610-521-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 W CHESTER PIKE STE 201",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190781629",
            "telephone_number": "610-521-1701",
            "fax_number": "610-521-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "MARTIN",
        "middle_name": "JAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD030099E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1079883",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Kay Ayre
• Brook H Batzel, MSN, CRNP
• Gary Lee Becker, MD
• Aimee M Belfon, CRNA
• Kerry Jane Benson
• Rachel Bernard, PA-C
• Bestcare Nursing and Residential Services, Inc.
• Christine L. Blaine, PSY.D.
• Peter A Bodi, PA-C
• Lee H Bogart, M.D.

• Rheumatology Physician in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Rheumatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.