Gregory Walter Bergner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G34890 Issued in CA

Practice address

1067 4TH St
South Lake Tahoe, CA 96150-3459

Phone

(530) 600-1960

Fax

(530) 542-4372

NPI assigned

Jul 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Barton Healthcare System

  • Internal Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1235196015

  CA, Family Medicine

  Medicare reassignment NPD
• Tahoe Carson Valley Medical Group Inc

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1508865528

  CA

  Medicare reassignment
• Barton Healthcare System

  • Diagnostic Radiology Physician
  • Stateline, NV
  • NPI 1467046102
  NPD

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851398671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 4TH ST",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503459",
            "telephone_number": "530-600-1960",
            "fax_number": "530-542-4372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2170 South Ave",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961507026",
            "country_code": "US",
            "telephone_number": "530-541-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGNER",
        "first_name": "GREGORY",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G34890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Joseph Barulich III, MD
• Ashley Elizabeth Bedell
• Sarah Elizabeth Belknap, SLP
• Susan Ariana Tarisa Benham
• Nicholas G Bennett, M.D.
• Sarah Berlin
• Linda Hardin Bingham, MSW
• Marta Biniewicz McLean, LMFT
• Cascade Bishop
• Madeleine Bishop

• All providers in South Lake Tahoe, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.