PAUL A BERGER M.D.
NPI 1861474488
Family Medicine in Thornton, CO

Q: What is Paul Berger's NPI number?

The NPI number for Paul Berger is 1861474488. It was assigned to this individual provider in the NPPES registry on November 18, 2005.

Q: What is Paul Berger's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Paul Berger was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 18, 2005PECOS EnrolledAccepts Medicare Assignment

77.17/100

CMS Quality Rating

4075 E 128TH AVE, THORNTON, CO 80241(303) 925-4210(303) 925-4212 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Nov 26, 2019, Jun 7, 2017 (3 updates tracked since 2017).

On this page

About Paul A Berger M.d. NPPES

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

PAUL A BERGER M.D. (NPI 1861474488) is an individual family medicine provider in Thornton, Colorado, licensed in Colorado (35393) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Minnesota Medical School (1992).

NPPES Registry Identity

NPI1861474488

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePAUL A BERGERCredential: M.D.

Location Address4075 E 128TH AVEThornton, CO 80241-2201

Mailing Address7233 Church Ranch BlvdWestminster, CO 80021-4094 · (303) 925-4940 · Fax (303) 925-4212

Phone(303) 925-4210

Fax(303) 925-4212

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1992

Enumeration DateNovember 18, 2005

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1861474488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CO · 35393

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.

4075 E 128TH AVE, Thornton, CO 80241

Open in Google Maps ↗

Other Identifiers 1

Medicaid01353937CO

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Paul A Berger M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052334802

PECOS Enrollment IDI20060109000206

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

173 services106 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

88 services64 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

58 services58 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

18 services18 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80241 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$89.43 typical visit price

range $58.06 – $174.82

Typical copayment $22.35 (range $14.51 – $43.70)

Most-billed visit code 99203

Established Patient

$102.03 typical visit price

range $18.88 – $142.79

Typical copayment $25.50 (range $4.72 – $35.69)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

77.17/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

80.27

Promoting Interoperability

Improvement Activities

Cost

59.47

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers14 claims14 services$55.56 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

KRYSTAL L STARNES NP

Nurse Practitioner (Family)