Active NPI
Michael T Berstler, MD
- Family Medicine Physician
- Waverly, IA
National Provider Identifier
1992781793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20725
- Practice address
- 312 9TH St SW
Suite 1200
Waverly, IA 50677-2929 - Phone
- (319) 352-4340
- Fax
- (319) 352-0745
- NPI assigned
- Dec 22, 2005
- Last updated
- May 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20725 | IA | Primary |
Addresses
Primary practice location
312 9TH St SW
Suite 1200
Waverly, IA 50677-2929
Mailing address
312 9TH St SW
Suite 1200
Waverly, IA 50677-2929
Phone (319) 352-4340
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080078030 | Other | IA | RR MEDICARE |
| 0160697 | Medicaid | IA | |
| 1992781793 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20725 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd County Memorial Hospital Commission | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Charles City, IA
- NPI 1265402390
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337644800000",
"number": "1992781793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 9TH ST SW",
"address_2": "SUITE 1200",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772929",
"telephone_number": "319-352-4340",
"fax_number": "319-352-0745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 9TH ST SW",
"address_2": "SUITE 1200",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772929",
"telephone_number": "319-352-4340",
"fax_number": "319-352-0745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERSTLER",
"first_name": "MICHAEL",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2012-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "20725",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "080078030",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0160697",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992781793",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waverly, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.