Wade Scott Berger, MBA, CCP, SA-C

Primary specialty

PerfusionistTaxonomy code 242T00000X

License

FPF00001162 Issued in TX

Practice address

2203 Woodmen Dr
San Antonio, TX 78209-4278

Phone

(979) 743-0508

NPI assigned

Aug 1, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

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.

• Evt, Inc

  • Cardiovascular Specialist/Technologist
  • San Antonio, TX
  • NPI 1235469941
  NPD (past)

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1922354539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 WOODMEN DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094278",
            "telephone_number": "979-743-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 WOODMEN DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094278",
            "telephone_number": "979-743-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "WADE",
        "middle_name": "SCOTT",
        "credential": "MBA, CCP, SA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "15593",
            "primary": false
        },
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "TX",
            "license": "FPF00001162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Berg, DC
• Kelsi Berg
• Samuel Paul Berg, RN
• Gail Theresa Bergen X, DA
• Courtney Marie Berger
• Jennifer Lynn Bergeron, M.D.
• Bergfeld Physician Services PA
• Deborah Bergfeld, MD
• Lindsey Hart Bergman, M.D.
• Bergmann Counseling PLLC

• Perfusionist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Perfusionist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.