Individual provider Active NPI

Daniel J Berger, MD

  • Family Medicine Physician
  • Bristol, IN
National Provider Identifier
1831166362
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01055284A Issued in IN
Practice address
304 E Vistula St
Bristol, IN 46507
Phone
(574) 848-4039
NPI assigned
Mar 3, 2006
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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 01055284A IN Primary

Addresses

Primary practice location

304 E Vistula St
Bristol, IN 46507

Mailing address

304 E Vistula St
Bristol, IN 46507-9489

Other practice location 1

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 535-1700

Other identifiers 1

IdentifierTypeStateIssuer
200385260MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daniel.berger@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040617001653 IN Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 2769466408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

1701 S Main St
Goshen, IN 46526-4723
Phone (574) 364-2875

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01055284AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc Family Medicine CurrentSince Apr 22, 2004 Accepting new patients
Goshen Health System Inc CurrentSince Apr 22, 2004 Accepting new patients
Goshen Hospital Association Inc Current Accepting new patients
St. John Physicians, Inc PastSince May 10, 2011 Accepting new patients
Gemini Medical Group Family Medicine Past Accepting new patients
Gemini Medical Group Inc Family Medicine Past Accepting new patients

Locations

304 E Vistula St
Bristol, IN 46507
Phone (574) 848-4039

3421 S Main St
Elkhart, IN 46517
Phone (219) 293-2548

1701 S Main St
Goshen, IN 46526

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

Organizations & group practices 6

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1831166362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E VISTULA ST",
            "city": "BRISTOL",
            "state": "IN",
            "postal_code": "465079489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 E VISTULA ST",
            "city": "BRISTOL",
            "state": "IN",
            "postal_code": "46507",
            "telephone_number": "574-848-4039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2824 Elkhart Rd",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "46526",
            "country_code": "US",
            "telephone_number": "574-535-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGER",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01055284A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200385260",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniel.berger@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "304 E Vistula St",
            "city": "Bristol",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bristol, IN

Sources for this page

Verify at the official NPI Registry.