Individual provider Active NPI

Eric J Bersagel, MD

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1902852601
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35054084 Issued in OH
Practice address
6001 E Broad St
Columbus, OH 43213-1502
Phone
(614) 234-6000
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35054084 OH Primary

Addresses

Primary practice location

6001 E Broad St
Columbus, OH 43213-1502

Mailing address

4165 Van Fossen Rd
Johnstown, OH 43031-9421
Phone (740) 967-9160

Other identifiers 1

IdentifierTypeStateIssuer
0685683MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35054084OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Health Past Accepting new patients
Mount Carmel Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ebersagel1155105@direct.trinity-health.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1902852601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 VAN FOSSEN RD",
            "city": "JOHNSTOWN",
            "state": "OH",
            "postal_code": "430319421",
            "telephone_number": "740-967-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131502",
            "telephone_number": "614-234-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSAGEL",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35054084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0685683",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.