Jack Alton Bergh, MD - Medicare Family Medicine in Lutz, FL

Jack Alton Bergh, MD is a medicare enrolled "Family Medicine" physician in Lutz, Florida. His current practice location is 1539 Dale Mabry Hwy Ste 102, Lutz, Florida. You can reach out to his office (for appointments etc.) via phone at (813) 909-7102.

Jack Alton Bergh is licensed to practice in Florida (license number ME0056971) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376506394.

Contact Information

Jack Alton Bergh, MD
1539 Dale Mabry Hwy Ste 102,
Lutz, FL 33548
(813) 909-7102
(813) 909-0199

Map and Direction




Physician's Profile

Full NameJack Alton Bergh
GenderMale
SpecialityFamily Medicine
Location1539 Dale Mabry Hwy Ste 102, Lutz, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1376506394
  • Provider Enumeration Date: 04/10/2006
  • Last Update Date: 01/08/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 8224090709
  • Enrollment ID: I20041027000814

Medical Identifiers

Medical identifiers for Jack Alton Bergh such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376506394NPI-NPPES
770008300MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine ME0056971 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jack Alton Bergh allows following entities to bill medicare on his behalf.
Entity NameWellmed Medical Management Of Florida Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033395397
PECOS PAC ID: 3971678558
Enrollment ID: O20080815000432

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Alton Bergh is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jack Alton Bergh, MD
14743 Morning Dr,
Lutz, FL 33559-3257

Ph: (813) 975-4743
Jack Alton Bergh, MD
1539 Dale Mabry Hwy Ste 102,
Lutz, FL 33548

Ph: (813) 909-7102

Reviews and Comments


Family Medicine Doctors in Lutz, FL

Dr. Myra C Gibson, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 4123 Highland Park Cir, Lutz, FL 33558
Phone: 813-482-5291    
Dr. Eric Joseph Crall, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 4953 Van Dyke Rd, Lutz, FL 33558
Phone: 813-321-1783    Fax: 877-992-2302
Dr. Ronald Eugene Stephans Jr., MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 4211 Van Dyke Rd, Suite B, Lutz, FL 33558
Phone: 813-960-4026    Fax: 813-960-4489
Andres Santayana, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 17724 Hunting Bow Cir Ste 101, Lutz, FL 33558
Phone: 813-723-5456    Fax: 813-723-5457
Dr. Tad Robert Connine, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 23546 State Road 54, Lutz, FL 33559
Phone: 813-990-7443    Fax: 813-864-7443
Dr. Erika M. Agnew, D.O.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 4211 Van Dyke Rd Ste 101b, Lutz, FL 33558
Phone: 813-960-4026    Fax: 813-443-8166

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.