NPIMap

Individual provider Active NPI

Marshall Barr Bergen, CRNA

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
National Provider Identifier
1003578568
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
269219 Issued in AZ
Practice address
4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978
Phone
(480) 256-1518
Fax
(480) 304-3446
NPI assigned
Oct 12, 2021
Last updated
Feb 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 269219 AZ Primary
Registered Nurse 163W00000X RN192249 AZ

Addresses

Primary practice location

4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978

Mailing address

1526 E Beacon Dr
Gilbert, AZ 85234-2674
Phone (480) 282-2011

Other identifiers 1

IdentifierTypeStateIssuer
269219OtherAZARIZONA NURSING BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220510000365 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426435652 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Copper Star Anesthesia LLCGroup PAC ID 7416342084, 3 clinicians
Greater Anesthesia SolutionsGroup PAC ID 9234357906, 210 clinicians
Ascend Anesthesia LLCGroup PAC ID 5294246526, 76 clinicians

Practice addresses (Care Compare)

Tempe, AZ 85282
Phone (480) 425-2160

14502 W Meeker Blvd
Sun City, AZ 85375-5282
Phone (623) 524-4000

3929 E Bell Rd
Phoenix, AZ 85032-2112
Phone (602) 923-5609

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.31 of 100Reported as group
Quality
74.88
Improvement activities
0
Cost
73.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN192249AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
MB Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2024 Accepting new patients
Greater Anesthesia Solutions Nurse Anesthetist, Certified Registered CurrentSince Aug 31, 2023 Accepting new patients
Copper Star Anesthesia, LLC CurrentSince Jul 1, 2025 Accepting new patients
Arizona Spine and Joint Hospital LLC Current Accepting new patients
Ascend Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
Anesthesia Partners of Arizona LLC CurrentSince Feb 4, 2022 Accepting new patients
Summit Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince May 12, 2024 Accepting new patients
Pinnacle Global Health LLC Past Accepting new patients

Locations

560 N Switzer Canyon Dr
Flagstaff, AZ 86001
Phone (928) 774-3044

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

135 N Center St
Unit 5870
Mesa, AZ 85211

20 W 1st St
Ste 201
Mesa, AZ 85201

6003 E Baseline Rd
Mesa, AZ 85206
Phone (480) 641-6500

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

1902 W Union Hills Dr
Unit 41340
Phoenix, AZ 85080

1902 W Union Hills Dr
Unit 41550
Phoenix, AZ 85080

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

2421 E Southern Ave
Ste 7
Tempe, AZ 85282
Phone (480) 832-3600

Interoperability endpoints

  • Direct secure messaging: marshallbergen@asjh.medalliesdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1003578568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 E BEACON DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342674",
            "telephone_number": "480-282-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 E ELWOOD ST STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850401978",
            "telephone_number": "480-256-1518",
            "fax_number": "480-304-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "MARSHALL",
        "middle_name": "BARR",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-12",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "269219",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN192249",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA NURSING BOARD",
            "identifier": "269219",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.