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SHANE RICHARD BERGER
NPI 1760236111
Student in an Organized Health Care Education/Training Program in Fairborn, OH

Active since April 12, 2024PECOS Enrolled
2555 UNIVERSITY DR, FAIRBORN, OH 45324(937) 775-7792 Get Directions Write a Review

NPPES record last updated: April 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shane Richard Berger NPPES

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

SHANE RICHARD BERGER (NPI 1760236111) is an individual student in an organized health care education/training program in Fairborn, Ohio and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760236111
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSHANE RICHARD BERGER
Location Address2555 UNIVERSITY DRFairborn, OH 45324-6255
Mailing Address2555 University DrFairborn, OH 45324-6255
Phone(937) 775-7792
Sole ProprietorNo
Enumeration DateApril 12, 2024
NPPES CertifiedApril 12, 2024
✔ NPI 1760236111 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.
2555 UNIVERSITY DR, Fairborn, OH 45324
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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)

Shane Richard Berger 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 20

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

SAUMIA THOMAS DO
Psychiatry & Neurology (Psychiatry)
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792
DR. ANDREW WAYNE DOBRY JR. MD
Psychiatry & Neurology (Psychiatry)
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792
SANA SHAMEEM MD
Student in an Organized Health Care Education/Training Program
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792
SETH HOLMQUIST
Student in an Organized Health Care Education/Training Program
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792
JULIE MCCORMACK
Psychiatry & Neurology (Psychiatry)
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792
LOGAN CERWIN YUSUF DO
Student in an Organized Health Care Education/Training Program
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792
AIDAN JAMES VATALARO
Student in an Organized Health Care Education/Training Program
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792
NOOR GUL HAQ DO
Student in an Organized Health Care Education/Training Program
2555 UNIVERSITY DR
FAIRBORN, OH 45324
Greene County (937) 775-7792

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 Shane Berger's NPI number?

The NPI number for Shane Berger is 1760236111. It was assigned to this individual provider in the NPPES registry on April 12, 2024.

Where is Shane Berger located?

Shane Berger practices at 2555 University Dr, Fairborn, OH 45324. The listed phone number is (937) 775-7792.

What is Shane Berger's specialty?

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

Is Shane Berger enrolled in Medicare?

Yes. Shane Berger is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shane Berger was last updated on April 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.