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JACOB MARTIN BERG
NPI 1023769288
Student in an Organized Health Care Education/Training Program in Lebanon, OR

Active since January 10, 2022PECOS Enrolled
200 MULLINS DRIVE, LEBANON, OR 97355(541) 259-0235 Get Directions Write a Review

NPPES record last updated: January 10, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Martin Berg NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB MARTIN BERG (NPI 1023769288) is an individual student in an organized health care education/training program in Lebanon, Oregon and active in the NPI registry since January 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023769288
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB MARTIN BERG
Location Address200 MULLINS DRIVELebanon, OR 97355-3983
Mailing Address200 Mullins DriveLebanon, OR 97355-3983 · (541) 259-0235
Phone(541) 259-0235
Sole ProprietorYes
Enumeration DateJanuary 10, 2022
NPPES CertifiedJanuary 10, 2022
✔ NPI 1023769288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
200 MULLINS DRIVE, Lebanon, OR 97355
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Martin Berg is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAILIN JOHNSON
Student in an Organized Health Care Education/Training Program
200 MULLINS DRIVE
LEBANON, OR 97355
Linn County (541) 259-0235
CARL HENRY BENSON
Student in an Organized Health Care Education/Training Program
200 MULLINS DRIVE
LEBANON, OR 97355
Linn County (541) 259-0235
DEREK DENG
Family Medicine
200 MULLINS DRIVE
LEBANON, OR 97355
Linn County (541) 259-0235

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Berg's NPI number?

The NPI number for Jacob Berg is 1023769288. It was assigned to this individual provider in the NPPES registry on January 10, 2022.

Where is Jacob Berg located?

Jacob Berg practices at 200 Mullins Drive, Lebanon, OR 97355. The listed phone number is (541) 259-0235.

What is Jacob Berg's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Berg enrolled in Medicare?

Yes. Jacob Berg is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Berg was last updated on January 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.