Individual provider Active NPI

Brian Max Berger, M.D.

  • Reproductive Endocrinology Physician
  • Quincy, MA
National Provider Identifier
1811934557
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
157527 Issued in MA
Practice address
2300 Crown Colony Dr
Boston Ivf- the South Shore Center
Quincy, MA 02169-0902
Phone
(617) 793-1100
Fax
(617) 793-1175
NPI assigned
Jun 1, 2006
Last updated
Oct 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 157527 MA Primary
Reproductive Endocrinology Physician 207VE0102X MD10797 RI
Gynecology Physician 207VG0400X 157527 MA
Gynecology Physician 207VG0400X MD10797 RI

Addresses

Primary practice location

2300 Crown Colony Dr
Boston Ivf- the South Shore Center
Quincy, MA 02169-0902

Mailing address

2300 Crown Colony Dr
Boston Ivf- the South Shore Center
Quincy, MA 02169-0902
Phone (617) 793-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130809000460 MA Practitioner - Obstetrics/Gynecology 2668614215 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10797RIMDReproductive Endocrinology Physician
157527MAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 26, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 26, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients
Boston Ivf, Inc. Reproductive Endocrinology Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1811934557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CROWN COLONY DR",
            "address_2": "BOSTON IVF- THE SOUTH SHORE CENTER",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690902",
            "telephone_number": "617-793-1100",
            "fax_number": "617-793-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CROWN COLONY DR",
            "address_2": "BOSTON IVF- THE SOUTH SHORE CENTER",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690902",
            "telephone_number": "617-793-1100",
            "fax_number": "617-793-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "BRIAN",
        "middle_name": "MAX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MA",
            "license": "157527",
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "RI",
            "license": "MD10797",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MA",
            "license": "157527",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "RI",
            "license": "MD10797",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.