Individual provider Active NPI

Chrystal Summer Rose Berg, D.P.M.

  • Podiatrist
  • Denver, CO
National Provider Identifier
1023230802
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD-663 Issued in CO
Practice address
777 Bannock St
MC 0188
Denver, CO 80204-4507
Phone
(303) 436-6131
Fax
(303) 436-6572
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD-663 CO Primary

Addresses

Primary practice location

777 Bannock St
MC 0188
Denver, CO 80204-4507

Mailing address

1010 N Country Club Dr
Mesa, AZ 85201-3309
Phone (480) 461-2409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081027000889 CO Practitioner - Podiatry 4284792722 Reassigns benefits to 2 organizations
I20210714000522 IL Practitioner - Podiatry 4284792722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Podiatry Group PCGroup PAC ID 3971412677, 131 clinicians

Practice addresses (Care Compare)

10 W Monument St
Colorado Springs, CO 80903-3216
Phone (719) 635-6300

168 N Clinton St
FL 3
Chicago, IL 60661-1425
Phone (847) 504-5000

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue34
Removal of nail tissue2155
Removal or shaving of skin growth779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD-663COMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Podiatrist CurrentSince Jul 1, 2021 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 28, 2008 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 28, 2008 Accepting new patients

Locations

10 W Monument St
Colorado Springs, CO 80903
Phone (719) 635-6300

777 Bannock St
#188
Denver, CO 80204
Phone (303) 602-1590

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

1330 Sidney Ave
Sterling, CO 80751
Phone (970) 522-4888

168 N Clinton St
Fl 3
Chicago, IL 60661
Phone (201) 856-0224

1201 N Alton St
Lebanon, IL 62254
Phone (618) 537-4401

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1023230802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013309",
            "telephone_number": "480-461-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "address_2": "MC 0188",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-6131",
            "fax_number": "303-436-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "CHRYSTAL",
        "middle_name": "SUMMER ROSE",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "POD-663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.