David Berg, PA
Individual provider Active NPI Physician Assistant · Beth Page, NY
NPI 1891747739 · NPPES record last updated May 14, 2008
Key facts
- NPI
- 1891747739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 010964 (NY)
- Practice address
- 4295 Hempstead Turnpike
ER Dept Island Medical Physicians
Beth Page, NY 11714 - Phone
- (516) 579-6000
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Samaritan Medical Services PC
Practice addresses (Care Compare)
100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 325-7520
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689
Hospital & facility affiliations
- St Francis Hospital - the Heart Center
- Good Samaritan Hospital Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060428000184 | NY | Practitioner - Physician Assistant | 7719997246 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 161497 | NY | MD | Anesthesiology Physician |
| 010964 | NY | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 010964 | NY | Yes |
Addresses
Primary practice location
4295 Hempstead Turnpike
ER Dept Island Medical Physicians
Beth Page, NY 11714
Mailing address
PO Box 826186
David Berg PA
Philadelphia, PA 19182
Phone (800) 795-5820
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.