Individual provider Active NPI

Alycia K Berg, MA, CCC-SLP

  • Speech-Language Pathologist
  • St Thomas, VI
National Provider Identifier
1073619003
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6906 Issued in MA
Practice address
6115 Estate Smith Bay Ste 334
St Thomas, VI 00802-1324
Phone
(340) 714-2348
Fax
(781) 647-8914
NPI assigned
Sep 16, 2006
Last updated
Jul 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6906 MA Primary

Addresses

Primary practice location

6115 Estate Smith Bay Ste 334
St Thomas, VI 00802-1324

Mailing address

6115 Estate Smith Bay Ste 334
St Thomas, VI 00802-1324
Phone (340) 714-2348

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200617000756 VI Practitioner - Qualified Speech Language Pathologist 6305268533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Fitness and Wellness Center LLCGroup PAC ID 2365663267, 6 clinicians

Practice addresses (Care Compare)

6115 Estate Smith Bay
Suite 334 335
St Thomas, VI 00802-1324
Phone (340) 714-2348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Fitness and Wellness Center LLC Speech-Language Pathologist CurrentSince Jun 12, 2020 Accepting new patients

Locations

6115 Estate Smith Bay
Ste 334
St Thomas, VI 00802
Phone (340) 626-8106

6115 Estate Smith Bay
Ste 334335
St Thomas, VI 00802
Phone (340) 513-9166

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1073619003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 ESTATE SMITH BAY STE 334",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008021324",
            "telephone_number": "340-714-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 ESTATE SMITH BAY STE 334",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008021324",
            "telephone_number": "340-714-2348",
            "fax_number": "781-647-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "ALYCIA",
        "middle_name": "K",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "6906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Thomas, VI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.