Individual provider Active NPI

Mark Craig Berndt, PA

  • Surgical Physician Assistant
  • Birmingham, AL
National Provider Identifier
1063300465
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2754 Issued in AL
Practice address
1716 9TH Ave S
Birmingham, AL 35233-1124
Phone
(205) 934-4194
NPI assigned
Jun 25, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X 2754 AL Primary

Addresses

Primary practice location

1716 9TH Ave S
Birmingham, AL 35233-1124

Mailing address

PO Box 370
Fortson, GA 31808-0370

Other practice location 1

2173 Normandie Dr
Montgomery, AL 36111-2728
Phone (334) 438-2642

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260313003591 AL Practitioner - Physician Assistant 1456834704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians
Hughston Clinic Southeast PCGroup PAC ID 9234423971, 48 clinicians

Practice addresses (Care Compare)

2010 Brookwood Med Ctr Dr
Birmingham, AL 35209-6804
Phone (205) 537-3337

2173 Normandie Dr
Montgomery, AL 36111-2728
Phone (334) 438-2642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2754ALMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Clinic Southeast PC Multi-Specialty CurrentSince Feb 27, 2026 Accepting new patients
Hughston Clinic Southeast PC CurrentSince Feb 27, 2026 Accepting new patients

Locations

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

2173 Normandie Dr
Montgomery, AL 36111
Phone (334) 284-2355

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1063300465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 9TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331124",
            "telephone_number": "205-934-4194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2173 Normandie Dr",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361112728",
            "country_code": "US",
            "telephone_number": "334-438-2642",
            "fax_number": "844-689-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNDT",
        "first_name": "MARK",
        "middle_name": "CRAIG",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "2754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.