DR. DONALD ARTHUR BERGMAN M.D. NPI 1013085596
Internal Medicine - Endocrinology, Diabetes & Metabolism in New York, NY

About DR. DONALD ARTHUR BERGMAN M.D.

Donald Bergman is an internist established in New York, New York and his medical specialization is Internal Medicine with a focus in endocrinology, diabetes & metabolism with more than 52 years of experience. He graduated from Jefferson Medical College Of Thomas Jefferson University in 1971. The NPI number of Donald Bergman is 1013085596 and was assigned on December 2006. The practitioner's primary taxonomy code is 207RE0101X with license number 112384 (NY). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1013085596
Provider NameDR. DONALD ARTHUR BERGMAN M.D.
Location Address1199 PARK AVE SUITE 1F NEW YORK, NY 10128
Location Phone(212) 876-7333
Mailing Address1199 PARK AVE SUITE 1F NEW YORK, NY 10128
GenderMale
NPI Entity TypeIndividual
Medical School NameJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduation Year1971
Is Sole Proprietor?No
Enumeration Date12-01-2006
Last Update Date07-23-2008

An internist like Dr. Donald Arthur Bergman M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Donald Bergman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Donald Bergman is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services. According to Medicare claims data he has hospital affiliations with Hospital For Special Surgery and Suny/stony Brook University Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 30, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code207RE0101X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationEndocrinology, Diabetes & Metabolism
License No.112384
License StateNY
Taxonomy DescriptionAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

DR. DONALD ARTHUR BERGMAN M.D.
1199 PARK AVE
SUITE 1F
NEW YORK, NY
ZIP 10128
Phone: (212) 876-7333
Fax: (212) 876-5351

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Mailing Address

DR. DONALD ARTHUR BERGMAN M.D.
1199 PARK AVE
SUITE 1F
NEW YORK, NY
ZIP 10128
Phone: (212) 876-7333
Fax: (212) 876-5351


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID7719144724
PECOS Enrollment IDI20120202000614
Accepts Medicare Assignment? Maybe "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% N/A
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% N/A
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 30
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 853Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 535Ultrasound of head and neck (HCPCS:76536)
  • 79Fine needle aspiration using imaging guidance (HCPCS:10022)
  • 47Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Donald Bergman is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
HOSPITAL FOR SPECIAL SURGERY535 EAST 70TH STREET
NEW YORK, NY 10021
(212) 606-1000Acute Care Hospitals330270
SUNY/STONY BROOK UNIVERSITY HOSPITALHEALTH SCIENCES CENTER SUNY
STONY BROOK, NY 11794
(631) 444-4000Acute Care Hospitals330393

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
C08001MEDICARE UPIN (02)NY
298171OTHER (01)NYMEDICARE PROVIDER

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1013085596
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20230810518
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 1 + 0 + 5 + 1 + 8 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1013085596 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1013018068DR. LEONARD MICHAEL MATTES M.D.
Individual
Internal Medicine (Cardiovascular Disease)1199 PARK AVE SUITE 1F
NEW YORK, NY 10128
(212) 876-7045
1205960259 GAIL S. REED PH.D., L.P.
Individual
Counselor (Mental Health)1199 PARK AVE 1-G
NEW YORK, NY 10128
(212) 831-3274
1518183201DR. NANCY BODEN ZVONKOVIC PSY.D.
Individual
Psychologist1199 PARK AVE APT. IC
NEW YORK, NY 10128
(212) 996-5413
1023395654LEONARD M. MATTES M.D., P.C.
Organization
Internal Medicine (Cardiovascular Disease)1199 PARK AVE SUITE 1F
NEW YORK, NY 10128
(212) 876-7045
1003241225MAXINE L. GANN PSYCHOLOGIST, P.C.
Organization
Psychologist1199 PARK AVE SUITE 1K
NEW YORK, NY 10128
(212) 860-3368
1396153920DONALD A. BERGMAN MD PC
Organization
Internal Medicine (Endocrinology, Diabetes & Metabolism)1199 PARK AVE SUITE 1F
NEW YORK, NY 10128
(212) 876-7333
1972884153DOUGLAS PSYCHOTHERAPY SERVICES, LCSW, PC
Organization
Social Worker (Clinical)1199 PARK AVE SUITE 1C
NEW YORK, NY 10128
(212) 828-7473
1639710817 AYHANNA N WILLIAMS
Individual
Counselor (Mental Health)1199 PARK AVE
NEW YORK, NY 10128
(212) 828-7476

Frequently Asked Questions

What is Dr. Donald Bergman M.D. NPI number?

The NPI number assigned to Dr. Donald Bergman M.D. is 1013085596, registered as an "individual" on December 01, 2006

Where is Dr. Donald Bergman M.D. located?

The provider is located at 1199 Park Ave Suite 1f New York, Ny 10128 and the phone number is (212) 876-7333

Which is Dr. Donald Bergman M.D. specialty?

The provider's speciality is Internal Medicine with a focus in Endocrinology, Diabetes & Metabolism

How many years of experience does Dr. Donald Bergman M.D. have?

The provider has more than 52 years of experience. He graduated from Jefferson Medical College Of Thomas Jefferson University in 1971.

What insurance does Dr. Donald Bergman M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Donald Bergman M.D. registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

How much is a visit to Dr. Donald Bergman M.D.?

Medicare beneficiaries should expect a typical cost of $158.18 with an average copayment of $39.54 for new patient appointments. Established patients should expect a typical charge of $121.62 and an average copayment of 30.4. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Donald Bergman M.D.?

The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample, Ultrasound of head and neck, Fine needle aspiration using imaging guidance and Ultrasonic guidance imaging supervision and interpretation for insertion of needle.

Is Dr. Donald Bergman M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: HOSPITAL FOR SPECIAL SURGERY and SUNY/STONY BROOK UNIVERSITY HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Dr. Donald Bergman M.D. was last updated on December 01, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]