Individual provider Active NPI

Tamera Berget, PA-C

  • Surgical Physician Assistant
  • Middleton, WI
National Provider Identifier
1124083779
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1284-23 Issued in WI
Practice address
2275 Deming Way
Middleton, WI 53562-5527
Phone
(608) 417-8388
Fax
(608) 417-8389
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1284WIMDOccupational Therapist
1284-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Past Accepting new patients
Advanced Pain Management SC Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1284-23 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

2275 Deming Way
Middleton, WI 53562-5527

Mailing address

202 S Park St
Madison, WI 53715-1507
Phone (608) 417-6000

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
11886466OtherCAQH
42994600MedicaidWI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 23, 2014.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1124083779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151507",
            "telephone_number": "608-417-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 DEMING WAY",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625527",
            "telephone_number": "608-417-8388",
            "fax_number": "608-417-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGET",
        "first_name": "TAMERA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1284-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11886466",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42994600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.