Beth M Marshall-bergman, DO - Medicare Internal Medicine in Chicago, IL

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Beth M Marshall-bergman, DO is a medicare enrolled "Internal Medicine" physician in Chicago, Illinois. She graduated from medical school in 2011 and has 15 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Form Health Associates Ma, P.c. and her current practice location is 125 S Wacker Dr Ste 300, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (617) 505-1520.

Beth M Marshall-bergman is licensed to practice in Illinois (license number 036.135673) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1962791657.

Contact Information

Beth M Marshall-bergman, DO
125 S Wacker Dr Ste 300,
Chicago, IL 60606-4421
(617) 505-1520
(617) 928-8401

Map and Direction




Physician's Profile

Full NameBeth M Marshall-bergman
GenderFemale
SpecialityInternal Medicine
Experience15 Years
Location125 S Wacker Dr Ste 300, Chicago, Illinois
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Beth M Marshall-bergman graduated from medical school in 2011
  NPI Data:
  • NPI Number: 1962791657
  • Provider Enumeration Date: 04/04/2011
  • Last Update Date: 06/24/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 0840411328
  • Enrollment ID: I20141027000934

Medical Identifiers

Medical identifiers for Beth M Marshall-bergman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962791657NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 4856 (Tennessee)Secondary
207R00000XInternal Medicine 3894 (West Virginia)Secondary
207R00000XInternal Medicine C0750 (Kentucky)Secondary
207R00000XInternal Medicine 036.135673 (Illinois)Primary
207R00000XInternal Medicine 2877 (Alabama)Secondary
207R00000XInternal Medicine EMC0001956 (Michigan)Secondary
207R00000XInternal Medicine 30199 (Mississippi)Secondary
207R00000XInternal Medicine 91988 (Georgia)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Form Health Associates Ma, P.c.337595396135

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. Beth M Marshall-bergman allows following entities to bill medicare on her behalf.
Entity NameRush Oak Park Physicians Group Center For Diabetes And Endocrine
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841560141
PECOS PAC ID: 3971763707
Enrollment ID: O20120402000075
Entity NameRush Oak Park Physicians Group Adult Medicine
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548531924
PECOS PAC ID: 3476716523
Enrollment ID: O20120529000606
Entity NameForm Health Associates Ma Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386260594
PECOS PAC ID: 3375953961
Enrollment ID: O20201228002173

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. Beth M Marshall-bergman 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
Beth M Marshall-bergman, DO
109 State St Ste 5,
Boston, MA 02109-2906

Ph: (617) 505-1520		Beth M Marshall-bergman, DO
125 S Wacker Dr Ste 300,
Chicago, IL 60606-4421

Ph: (617) 505-1520

Reviews and Comments


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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.