Individual provider Active NPI

Renato Augusto Berger, M.D., F.A.A.P.

  • Pediatrics Physician
  • Coconut Creek, FL
National Provider Identifier
1811994528
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 80792 Issued in FL
Practice address
5300 W Hillsboro Blvd
Suite 110
Coconut Creek, FL 33073-4395
Phone
(954) 794-1360
Fax
(954) 794-1367
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME 80792 FL Primary

Addresses

Primary practice location

5300 W Hillsboro Blvd
Suite 110
Coconut Creek, FL 33073-4395

Mailing address

2021 NE 22ND Ter
Fort Lauderdale, FL 33305-2613
Phone (954) 794-1360

Other identifiers 1

IdentifierTypeStateIssuer
003725700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 80792FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All Better Pediatric Group, Inc Single Specialty Current Accepting new patients

Locations

5300 W Hillsboro Blvd
Ste 110
Coconut Creek, FL 33073
Phone (954) 794-1360

Interoperability endpoints

  • Direct secure messaging: rberger@abp.opdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1811994528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 NE 22ND TER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333052613",
            "telephone_number": "954-794-1360",
            "fax_number": "954-794-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W HILLSBORO BLVD",
            "address_2": "SUITE 110",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734395",
            "telephone_number": "954-794-1360",
            "fax_number": "954-794-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "RENATO",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.A.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 80792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003725700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.