Active NPI
Geoffrey Herbst Berg, MD
- Internal Medicine Physician
- Providence, RI
National Provider Identifier
1902804313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 05035
- Practice address
- 160 Wayland Ave
Providence, RI 02906-4304 - Phone
- (401) 521-1221
- Fax
- (401) 454-4189
- NPI assigned
- Jul 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 05035 | RI | Primary |
Addresses
Primary practice location
160 Wayland Ave
Providence, RI 02906-4304
Mailing address
160 Wayland Ave
Providence, RI 02906-4304
Phone (401) 521-1221
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 405576 | Other | RI | BLUE CHIP |
| 455099 | Other | TUFTS | |
| 7001787 | Medicaid | RI | |
| 2919 | Other | RI | BCBS |
| 04-02664 | Other | UNITED HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040726000083 | RI | Practitioner - Internal Medicine | 0345220703 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Warren Alpert Medical School of Brown University, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
160 Wayland Ave
Providence, RI 02906-4304
Phone (401) 521-1221
Hospital & facility affiliations
- Elara Caring
- Elmwood Home Care, Inc
- The Miriam Hospital
- Rhode Island Hospital
- Kent County Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05035 | RI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard J. Ruggieri, MD, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
160 Wayland Ave
Providence, RI 02906
Phone (401) 521-1221
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.
-
- Internal Medicine Physician
- Providence, RI
- NPI 1558480434
Internal Medicine, RI
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Warwick, RI
- NPI 1831196955
-
- Home Health Agency
- Providence, RI
- NPI 1184073058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338940800000",
"number": "1902804313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 WAYLAND AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064304",
"telephone_number": "401-521-1221",
"fax_number": "401-454-4189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 WAYLAND AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064304",
"telephone_number": "401-521-1221",
"fax_number": "401-454-4189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "GEOFFREY",
"middle_name": "HERBST",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-09",
"last_updated": "2012-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "05035",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "405576",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "455099",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7001787",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "2919",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "04-02664",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.