Active NPI
Merritt Jonathan Bern, MD
- Gastroenterology Physician
- Roanoke, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 01080690A
- Practice address
- 3 Riverside Cir
Carilion Clinic Gastroenterolgy Riverside 3
Roanoke, VA 24016-4955 - Phone
- (540) 224-5170
- Fax
- (540) 985-9418
- NPI assigned
- Jan 4, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 0101040654 | VA | |
| Gastroenterology Physician | 207RG0100X | 01080690A | IN | Primary |
Addresses
Primary practice location
3 Riverside Cir
Carilion Clinic Gastroenterolgy Riverside 3
Roanoke, VA 24016-4955
Mailing address
3 Riverside Cir
Carilion Clinic Gastroenterolgy Riverside 3
Roanoke, VA 24016-4955
Phone (540) 224-5170
Other practice location 1
11104 Parkview Circle Dr Ste 310
Fort Wayne, IN 46845-1733
Phone (260) 266-5230
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VVA900A | Other | VA | MEDICARE PTAN |
| 100009137 | Other | MC RAIL ROAD | |
| 006097839 | Medicaid | VA | |
| 260856 | Other | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- University of Miami, LM Miller School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
744 W Michigan Ave
201 Henry Ford Allegiance Gastroenterology
Jackson, MI 49201-1900
Phone (517) 205-7618
Hospital & facility affiliations
- Henry Ford Allegiance Health
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 110 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 172 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101040654 | VA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.a. Foote Memorial Hospital, Inc | Current | Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Gastroenterology | Current | Accepting new patients |
| W. a. Foote Memorial Hospital, Inc | Internal Medicine | Current | Accepting new patients |
| Henry Ford Pathology | Current | Accepting new patients | |
| Wa Foote Memorial Hospital, Inc | Past | Accepting new patients |
Locations
1100 E Michigan Ave
Ste 205
Jackson, MI 49201
Phone (517) 205-7618
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000
744 W Michigan Ave
Ste 201
Jackson, MI 49201
Phone (517) 205-7618
Interoperability endpoints
- mbern564868@direct.hfhs.org
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Jackson, MI
- NPI 1760437826
-
- Anatomic Pathology & Clinical Pathology Physician
- Detroit, MI
- NPI 1851410005
-
- Gastroenterology Physician
- Jackson, MI
- NPI 1326585522
-
- Physician Assistant
- Jackson, MI
- NPI 1538606348
-
- Emergency Medicine Physician
- Jackson, MI
- NPI 1265487722
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MI
- NPI 1053403402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543881600000",
"number": "1720066483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 RIVERSIDE CIR",
"address_2": "CARILION CLINIC GASTROENTEROLGY RIVERSIDE 3",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164955",
"telephone_number": "540-224-5170",
"fax_number": "540-985-9418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 RIVERSIDE CIR",
"address_2": "CARILION CLINIC GASTROENTEROLGY RIVERSIDE 3",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164955",
"telephone_number": "540-224-5170",
"fax_number": "540-985-9418"
}
],
"practiceLocations": [
{
"address_1": "11104 Parkview Circle Dr Ste 310",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468451733",
"country_code": "US",
"telephone_number": "260-266-5230",
"fax_number": "260-266-5238",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERN",
"first_name": "MERRITT",
"middle_name": "JONATHAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2018-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "VA",
"license": "0101040654",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IN",
"license": "01080690A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "VVA900A",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MC RAIL ROAD",
"identifier": "100009137",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006097839",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "260856",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.