Douglas T Berger, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

C005104-1 Issued in NY

Practice address

2169 White Plains Rd
Bronx, NY 10462-1405

Phone

(718) 409-2200

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Creston Opticians Inc

  • Optometrist
  • Bronx, NY
  • NPI 1003973223

  Contact Lens

  NPD (past) Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1992862163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 SHERMAN AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664123",
            "telephone_number": "917-553-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2169 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621405",
            "telephone_number": "718-409-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "DOUGLAS",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FC0800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens",
            "state": "NY",
            "license": "C005104-1",
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "NY",
            "license": "C005104-1",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "C005104-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00960458",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bergen Dental Center LLP
• Alexandra Berger, MD
• Arielle Berger, M.D.
• Arthur Berger, EDD
• David Michael Berger, MD
• Jacob E. Berger, L.M.S.W.
• Jay Steven Berger, M.D./PH.D.
• Judith Joan Berger, MD
• Marina Berger, MSW
• Matthew A Berger, MD

• Optician in Bronx, NY
• Providers in Bronx, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.