Individual provider Active NPI

Eric D. Bergman, CRNA

  • Certified Registered Nurse Anesthetist
  • Boston, MA
National Provider Identifier
1720040033
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN241970 Issued in MA
Practice address
800 Washington St
Boston, MA 02111-1552
Phone
(617) 636-5000
NPI assigned
Apr 3, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN241970 MA Primary
Certified Registered Nurse Anesthetist 367500000X 511014 NY

Addresses

Primary practice location

800 Washington St
Boston, MA 02111-1552

Mailing address

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Other practice location 1

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-4305

Other practice location 2

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-4305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040814000224 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355314782 Reassigns benefits to 5 organizations
I20070907000052 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355314782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gbaa Holdings PLLCGroup PAC ID 4789944646, 22 clinicians
Dha Endoscopy LLCGroup PAC ID 4082614979, shared by 2 NPIs, 19 clinicians

Practice addresses (Care Compare)

45 A Discovery Way
Acton, MA 01720-4482
Phone (617) 936-7683

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

91 Montvale Ave
Suite 103
Stoneham, MA 02180-3649
Phone (781) 835-2111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
241970MAMDPediatric Nurse Practitioner
RN241970MAMDCertified Registered Nurse Anesthetist
511014NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jan 16, 2017 Accepting new patients
Albany Medical College Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
Albany Medical College Current Accepting new patients
Dha Endoscopy LLC CurrentSince May 4, 2020 Accepting new patients
Gbaa Holdings, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 18, 2017 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 30, 2012 Accepting new patients
Dha Endoscopy LLC CurrentSince May 4, 2020 Accepting new patients
Anesthetics of Massachusetts, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Central Mass Anesthesia Affiliates Inc. Past Accepting new patients
Anesthetics of Lowell, PC Past Accepting new patients
Upstate Anesthesia Services, P.C. Past Accepting new patients
Troy Infectious Disease and Primary Care LLC Past Accepting new patients

Locations

45 Discovery Way
#A
Acton, MA 01720
Phone (617) 936-7683

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200

91 Montvale Ave
Ste 103
Stoneham, MA 02180
Phone (781) 835-2111

175 Worcester St
Wellesley Hls, MA 02481
Phone (617) 272-0004

120 W Center St
West Bridgewater, MA 02379
Phone (508) 230-8181

43 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5149

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720040033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 New Scotland Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-4305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43 New Scotland Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-4305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "ERIC",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN241970",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "511014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.