Daniel Berg
Dermatology (MOHS-Micrographic Surgery)

Address: 1229 Madison Street, Suite 1090, Seattle, WA 98104
Phone: 2062153300

Daniel Berg (NPI# 1760549950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1760549950
Entity Type Individual
Full Name Daniel Berg
Credential M.D.
Gender Male
Practice Address 1229 Madison Street
Suite 1090
Seattle
WA 98104
Practice Telephone 2062153300
Practice Fax Number 2062153301
Mailing Address 1229 Madison Street
Suite 1090
Seattle
WA 98104
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2007-01-03
Last Update Date 2018-04-17

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 207N00000X Dermatology Allopathic & Osteopathic Physicians MD00035013 WA
Yes 207ND0101X Dermatology · MOHS-Micrographic Surgery Allopathic & Osteopathic Physicians MD00035013 WA

Other Provider Identifier

State Identifier Issuer Type Code
225990 OTHER INTERNAL ID-MOTOR VEHICLE ID
WA 0230738 OTHER L&I
WA 1760549950 MEDICAID

Other Providers DANIEL BERG

NPI Name Taxonomy Address Enumeration
1083718019 Daniel Robert Berg Optometrist 638 Marketplace Blvd, Hamilton, NJ 08691-2113 2006-09-11
1164817722 Daniel Berg Family Medicine 13450 S Kedzie Ave, Robbins, IL 60472 2015-03-31
1154581536 Daniel Berg Radiologic Technologist 420 4th St Ne Ste 122, Watertown, SD 57201-2658 2008-06-10
1689846875 Daniel A Berg Physical Therapy Assistant 1007 Johnstown Ave, Salina, KS 67401-3021 2008-03-27
1578636650 Daniel Eric Berg Internal Medicine 2211 Genesee St, Suite 200, Utica, NY 13501-5930 2006-11-16
1013947555 Daniel Ralph Berg Internal Medicine 401 Holly Hills Ave, Saint Louis, MO 63111-2410 2006-07-03
1659362069 Daniel R Berg Family Medicine 1400 1st St Ne, New Prague, MN 56071-2215 2005-11-03
1841289790 Daniel J Berg Internal Medicine 200 Hawkins Dr, Iowa City, IA 52242-1009 2005-10-13

Physician Overview

NPI 1760549950
PAC ID by PECOS 3971648908
Professional Enrollment ID I20100302000819
Full Name Daniel Berg
Organization Legal Name THE POLYCLINIC
Phone Number 2063091760
Gender M
Graduation Year 1985
Primary Specialty DERMATOLOGY
Group Practice PAC ID 2163328196
Number of Group Practice Members 358
Accepts Medicare Assignment Y
Report Quality Measures Y

Office Location

Street Address 1229 MADISON STREET
SUITE 1090
City SEATTLE
State WA
Zip Code 98104

Providers in the same location

NPI Name Taxonomy Address Enumeration
1225002967 Marybeth Arvidson Grazko Psychiatry & Neurology 1229 Madison Street, Suite 615, Seattle, WA 98104 2006-02-16
1194956607 Annie J Chandrankunnel Radiology 1229 Madison Street, Suite 900, Seattle, WA 98104 2009-07-31
1487711925 Michelle Marie Bittle Radiology 1229 Madison Street, Suite 900, Seattle, WA 98104 2007-01-03
1831262823 Anthony E Larhs Radiology 1229 Madison Street, Suite 900, Seattle, WA 98104 2006-11-16
1740369644 David Sw Djang Radiology 1229 Madison Street, Suite 1150, Seattle, WA 98104-3587 2006-11-03
1558440453 Marianne C Greenbaum Radiology 1229 Madison Street, Suite 1150, Seattle, WA 98104-3587 2006-11-03
1083793988 Eleanor V L Djang Radiology 1229 Madison Street, Suite 1150, Seattle, WA 98104-3587 2006-11-03
1518046416 Keith Y Wang Radiology 1229 Madison Street, Suite 1150, Seattle, WA 98104-3587 2006-11-03
1043399942 David R Haseley Radiology 1229 Madison Street, Suite 1150, Seattle, WA 98104-3587 2006-11-03
1114006913 Barry S Mahony Radiology 1229 Madison Street, Suite 1150, Seattle, WA 98104-3587 2006-11-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013480250 Robert Kenneth Lozier Pedorthist Norm Maleng Building, 410 9th Ave, 4th Floor, Seattle, WA 98104 2019-01-10
1548739576 Lee Hanses Physical Therapist 1124 Columbia Street, Level P1, Suite P100, Seattle, WA 98104 2018-11-20
1821579095 Karissa Lin Lee Pharmacist 401 Broadway #2075, Seattle, WA 98104 2018-08-27
1477042091 Maham Jehangir Student in an Organized Health Care Education/Training Program 325 9th Ave Department of Radiology, Seattle, WA 98104 2018-05-09
1740786581 Philip Daniel Tolley Student in an Organized Health Care Education/Training Program 325 9th Ave. Mail Stop#359796, 7th Floor Center Tower Rm #73.1, Seattle, WA 98104 2018-04-02
1528564242 Vanessa Dawn Leonhard Student in an Organized Health Care Education/Training Program 325 9th Ave, 7th Floor Center Tower Room 73.1, Mail Stop #359796, Seattle, WA 98104 2018-04-02
1225540545 Mary Elizabeth Micikas Registered Nurse 515 Minor Ave Ste 170, Seattle, WA 98104 2017-10-26
1033629506 Ashley Negron Registered Nurse Harborview Center for Sexual Assault and Tramautic Stre, 401 Broadway Suite 2075, Seattle, WA 98104 2017-10-10
1770018889 Alison S Bae Student in an Organized Health Care Education/Training Program 325 9th Ave, Mail Stop #359796, 7th Floor Center Tower Room 73.1, Seattle, WA 98104 2017-04-26
1083155329 Seatle Medical Supplies Durable Medical Equipment & Medical Supplies 800 Fifth Avenue, Seafirst Fifth Avenue Plaza, Suite 4100, Seattle, WA 98104 2017-03-20
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Taxonomy Information

Taxonomy Code 207ND0101X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization MOHS-Micrographic Surgery

Taxonomy Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1235217951 Jack E. Sebben Dermatology 1229 Madison St Ste 1480, Seattle, WA 98104-3538 2006-11-01
1386905917 Kelly Anne Griffith-bauer Dermatology 509 Olive Way Ste 200&900, Seattle, WA 98101-1720 2012-05-30
1730399270 Scott Normile Isenhath Dermatology 1229 Madison St, Seattle, WA 98104-3586 2007-05-23
1093896102 Peter Brierley Odland Dermatology 1229 Madison St, Suite 1480, Seattle, WA 98104-3586 2006-10-17
1780765800 Annalisa K Gorman Dermatology 1229 Madison St, Suite 1480, Seattle, WA 98104-3586 2006-10-17
1841371960 Skin Surgery Center, P.s. Dermatology 1229 Madison St, Suite 1480, Seattle, WA 98104-3586 2006-10-17
1386688380 Darrell Jonathan Fader Dermatology 1801 Nw Market St, Suite 107, Seattle, WA 98107-3987 2006-06-16
1023063716 Ravi S Krishnan Dermatology 1100 9th Ave, Seattle, WA 98101-2756 2006-05-23
1669422994 Craig Steven Birkby Dermatology 1229 Madison Street, Suite 1090, Seattle, WA 98104 2006-05-10
1700848355 Justin H Piasecki Dermatology 1101 Madison St, Suite 1270, Seattle, WA 98104-1306 2006-04-06
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City SEATTLE
Zip Code 98104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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