Dessa Marie Bergan

Primary specialty

Social WorkerTaxonomy code 104100000X

License

25032 Issued in MN

Practice address

715 Delmore Dr
Roseau, MN 56751-1534

Phone

(218) 463-2500

NPI assigned

Sep 14, 2018

Last updated

Sep 14, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northland Counseling Center IncGroup PAC ID 1153389242, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northland Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
  • NPI 1164610986
  Medicare reassignment Care Compare group NPD
• Northland Counseling Center Kooch Office

  • Community/Behavioral Health Agency
  • International Falls, MN
  • NPI 1720266794
  NPD

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1083197024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511534",
            "telephone_number": "218-463-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511534",
            "telephone_number": "218-463-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGAN",
        "first_name": "DESSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "25032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Altru Health System (Altru Health System-Renal Dialysis at Lifecare)
• Altru Health System (Altru Clinic - Roseau)
• Altru Specialty Services, Inc. (Yorhom Medical Essentials)
• Robert J Anderson, MD
• Kristine Benzie
• Miranda Ann Marie Bernath, FNP-C
• Bio-Medical Applications of Minnesota, Inc. (Fresenius Kidney Care Roseau)
• Sarah Blakeslee, MOTR/L
• David A Brett, D.O.
• Sara B Broten, PHARMD

• Social Worker in Roseau, MN
• Providers in Roseau, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.