Individual provider Active NPI

Paul D Berg, MD

  • Family Medicine Physician
  • Midland, MI
National Provider Identifier
1740377688
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301086022 Issued in MI
Practice address
4401 Campus Ridge Dr Ste 2100
Midland, MI 48640-6125
Phone
(989) 837-9300
Fax
(989) 837-9307
NPI assigned
Oct 10, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301086022 MI Primary

Addresses

Primary practice location

4401 Campus Ridge Dr Ste 2100
Midland, MI 48640-6125

Mailing address

4401 N Campus Ridge Dr
Ste D2100
Midland, MI 48640-6112
Phone (989) 837-9300

Other identifiers 1

IdentifierTypeStateIssuer
4301086022OtherMISTATE LICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080208000513 MI Practitioner - Family Practice 6901989284 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians
Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

4611 Campus Ridge Dr
Family Practice Center Midland
Midland, MI 48670-9533
Phone (989) 839-3500

5785 E Broadway Rd
Mt Pleasant, MI 48858-8987
Phone (989) 773-9421

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alpena CurrentSince Aug 1, 2008 Accepting new patients
Mymichigan Medical Center Sault Current Accepting new patients
Mymichigan Medical Center Sault CurrentSince Mar 14, 2024 Accepting new patients
Mymichigan Medical Group CurrentSince Aug 1, 2008 Accepting new patients
Mymichigan Medical Center Sault Family Medicine CurrentSince Mar 14, 2024 Accepting new patients
Mymichigan Medical Group Family Medicine Current Accepting new patients
Midmichigan Urgent Care Family Medicine Past Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

393 Long Rapids Rd
Alpena, MI 49707
Phone (989) 354-4406

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

3009 N Saginaw Rd
#C
Midland, MI 48640
Phone (989) 633-1350

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4401 N Campus Ridge Dr
Ste 2100
Midland, MI 48640
Phone (989) 837-9300

4401 N Campus Ridge Dr
Ste D2100
Midland, MI 48640
Phone (989) 837-9300

4851 E Pickard St
Mt Pleasant, MI 48858
Phone (989) 772-3009

5785 E Broadway Rd
Mt Pleasant, MI 48858
Phone (989) 773-9421

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

Interoperability endpoints

  • Direct secure messaging: pberg5880@mymichiganhealth.midirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Midmichigan Physicians Group Family MedicineAlpena, MI, CCN 233900 Rural health clinic Corporate Officer Aug 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 3

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740377688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 N CAMPUS RIDGE DR",
            "address_2": "STE D2100",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406112",
            "telephone_number": "989-837-9300",
            "fax_number": "989-837-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE 2100",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406125",
            "telephone_number": "989-837-9300",
            "fax_number": "989-837-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301086022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301086022",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.