Individual provider Active NPI

George Berberian, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Cape Girardeau, MO
National Provider Identifier
1962569046
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
2013021957 Issued in MO
Practice address
371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone
(573) 331-6710
NPI assigned
Jan 2, 2007
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2013021957 MO Primary

Addresses

Primary practice location

371 S Broadview St
Cape Girardeau, MO 63703-5761

Mailing address

371 S Broadview St
Cape Girardeau, MO 63703-5761

Other practice location 1

9 Park Pl
Swansea, IL 62226-2967
Phone (618) 233-5722

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gberberian363512@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120308000836 IL Practitioner - Thoracic Surgery 7214016658 Reassigns benefits to 1 organization
I20130925000526 MO Practitioner - Thoracic Surgery 7214016658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
New York University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9 Park PL
Swansea, IL 62226-2967
Phone (618) 233-5722

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013021957MOMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic Surgery Associates, P.C. Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Sep 1, 2022 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Jun 15, 2022 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jul 1, 2013 Accepting new patients
Southeast Hospital Current Accepting new patients
Prairie Cardiovascular Consultants LTD CurrentSince Sep 1, 2022 Accepting new patients
Bonaventure Medical Foundation, LLC PastSince Apr 1, 2009 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Lake-Porter Cardiovascular PC Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Mar 1, 2000 Accepting new patients

Locations

619 E Mason St
#4P57
Springfield, IL 62701

619 E Mason St
Ste 4
Springfield, IL 62701

9 Park Pl
Swansea, IL 62226
Phone (618) 233-5722

371 S Broadview St
Cape Girardeau, MO 63703
Phone (573) 331-6710

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
Ste 310
Joplin, MO 64804

Interoperability endpoints

  • Direct secure messaging: gberberian363512@ewd.direct.hshs.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1962569046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035761",
            "telephone_number": "573-331-6710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Park Pl",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622262967",
            "country_code": "US",
            "telephone_number": "618-233-5722",
            "fax_number": "618-233-7069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERBERIAN",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2013021957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gberberian363512@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "9 Park Pl",
            "city": "Swansea",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622262967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.