Individual provider Active NPI

Paul Henry Nieberg, MD

  • Infectious Disease Physician
  • Pasadena, CA
National Provider Identifier
1902909187
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A67350 Issued in CA
Practice address
960 E Green St Ste 105
Pasadena, CA 91106-2443
Phone
(626) 304-0782
Fax
(626) 310-0552
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X A67350 CA Primary

Addresses

Primary practice location

960 E Green St Ste 105
Pasadena, CA 91106-2443

Mailing address

PO Box 1449
Brea, CA 92822-1449
Phone (714) 996-1633

Other identifiers 4

IdentifierTypeStateIssuer
DB9540OtherGARAILROAD RETIREMENT
00A673500MedicaidCA
P00139012OtherCARAILROAD MEDICARE PROVIDE
00A673500OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040726000820 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 8022098375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Howard University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

960 E Green St
Suite 105
Pasadena, CA 91106-2443
Phone (626) 304-0782

Hospital & facility affiliations

  • Pasadena Home Health Care Home health agency, Pasadena, CA, CCN 058129
  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67350CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Foothill Pulmonary & Critical Care Consultants Medical Group Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1902909187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928221449",
            "telephone_number": "714-996-1633",
            "fax_number": "714-996-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST STE 105",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062443",
            "telephone_number": "626-304-0782",
            "fax_number": "626-310-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBERG",
        "first_name": "PAUL",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A67350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "DB9540",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A673500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDE",
            "identifier": "P00139012",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A673500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.