NPIMap

Individual provider Active NPI

Jake E Berg, DO

  • Emergency Medicine Physician
  • Marietta, OH
National Provider Identifier
1982286746
Registry record updated Mar 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.016875 Issued in OH
Practice address
401 Matthew St
Outreach/Ferguson Building
Marietta, OH 45750-4575
Phone
(740) 568-5669
NPI assigned
Apr 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 34.016875 OH Primary

Addresses

Primary practice location

401 Matthew St
Outreach/Ferguson Building
Marietta, OH 45750-4575

Mailing address

401 Matthew St
Outreach/Ferguson Building
Marietta, OH 45750
Phone (740) 568-5669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NC, GA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240327002681 OH Practitioner - Emergency Medicine 1658718531 Reassigns benefits to 3 organizations
I20250912000063 NC Practitioner - Emergency Medicine 1658718531 Reassigns benefits to 1 organization
I20260608004287 GA Practitioner - Emergency Medicine 1658718531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Georgia Emergency Department Services, P.C.Group PAC ID 5597751032, 76 clinicians

Practice addresses (Care Compare)

124 One Ctr CT
Franklin, NC 28734-0192
Phone (828) 524-8411

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 503-3000

Hospital & facility affiliations

  • Highlands Cashiers Hospital Hospital, Highlands, NC, CCN 341316
  • Angel Medical Center Hospital, Franklin, NC, CCN 341326
  • Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ues Ahuja LLC Emergency Medicine CurrentSince Oct 10, 2024 Accepting new patients
Emergency Medicine Physicians of Lake County LTD Emergency Medicine CurrentSince Mar 14, 2024 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Magis Emergency Medicine LLC Emergency Medicine CurrentSince Oct 10, 2024 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

124 One Center Ct
Franklin, NC 28734
Phone (828) 369-4214

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

3999 Richmond Rd
Cleveland, OH 44122
Phone (216) 293-8226

7007 Powers Blvd
Parma, OH 44129
Phone (440) 743-4000

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

Interoperability endpoints

  • Direct secure messaging: jberg576459@ehrdirect.uhhospitals.org

Organizations & group practices 5

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 6

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1982286746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "address_2": "OUTREACH/FERGUSON BUILDING",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-568-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "address_2": "OUTREACH/FERGUSON BUILDING",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457504575",
            "telephone_number": "740-568-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "JAKE",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.016875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.