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JACK ALTON BERGH MD
NPI 1376506394
Family Medicine in Lutz, FL

Active since April 10, 2006
84.85/100
CMS Quality Rating
1539 DALE MABRY HWY STE 102, LUTZ, FL 33548(813) 909-7102(813) 909-0199 Get Directions Write a Review

NPPES record last updated: January 8, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Alton Bergh Md NPPES

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

JACK ALTON BERGH MD (NPI 1376506394) is an individual family medicine provider in Lutz, Florida, licensed in Florida (ME0056971) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1376506394
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJACK ALTON BERGHCredential: MD
Location Address1539 DALE MABRY HWY STE 102Lutz, FL 33548
Mailing Address14743 Morning DrLutz, FL 33559-3257 · (813) 975-4743
Phone(813) 909-7102
Fax(813) 909-0199
Sole ProprietorNo
Enumeration DateApril 10, 2006
Last NPPES UpdateJanuary 8, 2013
✔ NPI 1376506394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME0056971
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1539 DALE MABRY HWY STE 102, Lutz, FL 33548
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Other Identifiers 3

Medicaid770008300FL
Medicare UPINE91794FL
Medicare ID-Type Unspecified12528FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.85/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality72.69
Promoting Interoperability95.03
Improvement Activities40

Other Providers at the Same Location NPPES 8

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

TANIABEX LOPEZ GARCIA MSW
Social Worker
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102
MYRTLE RIDGE HEALTHCARE CENTER, LLC
Nurse Practitioner (Adult Health)
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102
GEORGE MARCEL DORTA CHAPIN PA
Physician Assistant
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102
RAUL MEDINA ROJO MSN, APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102
MYRTLE RIDGE PRIMARY CARE, P.A
General Practice
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102
MYRTLE RIDGE PRIMARY CARE, P.A
Case Management
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102
MRS. YUDAISY MOGENA PADRON PA
Physician Assistant
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102
DAYANA FERNANDEZ-PACHECO GORRIN CBHCMS
Case Manager/Care Coordinator
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Hillsborough County (813) 909-7102

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 Jack Bergh's NPI number?

The NPI number for Jack Bergh is 1376506394. It was assigned to this individual provider in the NPPES registry on April 10, 2006.

Where is Jack Bergh located?

Jack Bergh practices at 1539 Dale Mabry Hwy Ste 102, Lutz, FL 33548. The listed phone number is (813) 909-7102.

What is Jack Bergh's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Jack Bergh accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Jack Bergh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Bergh was last updated on January 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.