Bradley R. Berg, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

N5567 Issued in TX

Practice address

425 University Blvd
Round Rock, TX 78665-1053

Phone

(512) 509-0200

Fax

(512) 218-6330

NPI assigned

Sep 23, 2005

Last updated

Dec 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Interoperability endpoints

• Direct secure messaging: bbergmd28494@direct.sw.org

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.

• Scott & White Clinic

  dba Baylor Scott & White Clinic - Temple

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704

  Pediatrics

  Medicare reassignment NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796

  Pediatrics

  NPD
• Scott and White Clinic

  • Radiation Oncology Physician
  • Waxahachie, TX
  • NPI 1821475153

  Pediatrics

  NPD
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1871589929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651053",
            "telephone_number": "512-509-0200",
            "fax_number": "512-218-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "BRADLEY",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00043078",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N5567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "263645",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8371452",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbergmd28494@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "425 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• April Nicole Benson
• Leah Benveniste, LCDC
• Daniel Benyamin, PA-C
• Solmaz Berenji
• Danielle Alyse Berenson, BCBA, LBA
• Marc George Bergeron, OD
• Anna Marie Bergquist, MD
• Senayit Berihun
• Katie Bermudez Medero
• Bernadette Brown, MD (Round Rock Pediatrics)

• Pediatrics Physician in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.