Kelly Berg, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9114955 Issued in FL

Practice address

1000 Waterman Way
Tavares, FL 32778-5266

Phone

(352) 253-3333

NPI assigned

Apr 11, 2022

Last updated

Apr 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians

Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
• Edgewater at Waterman Village Nursing home, Mount Dora, FL, CCN 105796

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kberg1682359@adventhealth.direct-ci.com

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.

• Florida Hospital Healthcare Partners, Inc

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1780100529
  Medicare reassignment Care Compare group
• Ronald Aung-Din, M.D., P.a.

  • Neurology Physician
  • Sarasota, FL
  • NPI 1053500124
  Medicare reassignment
• Bay Area Neurotech Services Inc

  • Neurology Physician
  • Sarasota, FL
  • NPI 1972141471
  NPD

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

• Florida Hospital Waterman Inc

  dba AdventHealth Waterman

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation
• Waterman Communities Inc

  • Skilled Nursing Facility
  • Mount Dora, FL
  • NPI 1063588226

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1013659937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785266",
            "telephone_number": "352-253-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9114955",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "PA9114955",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aida Behani, M.D.
• Behavioral Health Consultants
• Myriam Bellande, ST
• Norma Bennett
• David Bentley, PTA
• Kristy Michelle Beron, APRN
• Berry Orthotics & Prosthetics, Inc.
• Daniel Robert Berry, LPO
• Youstina Beshay, DDS
• Bevels Up Mobile Phlebotomy

• Surgical Physician Assistant in Tavares, FL
• Providers in Tavares, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.