Individual provider Active NPI

Jennifer Noel Berger, D.O

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1124464771
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
65386 Issued in MN
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(319) 356-4685
Fax
(612) 813-6000
NPI assigned
May 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X DO-04888 IA
Pediatrics Physician 208000000X 65386 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

2525 Chicago Ave
Minneapolis, MN 55404-4518

Other practice location 1

345 Smith Ave N
Saint Paul, MN 55102-2346
Phone (651) 220-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190912003566 MN Practitioner - Pediatric Medicine 6800192121 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
65386MNMDPediatrics Physician
DO-04888IAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Health Care CurrentSince Aug 19, 2019 Accepting new patients
Childrens Health Care CurrentSince Aug 19, 2019 Accepting new patients
Childrens Health Care Pediatrics Current Accepting new patients
Allina Health System Past Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

Organizations & group practices 4

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": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1124464771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "319-356-4685",
            "fax_number": "612-813-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Smith Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022346",
            "country_code": "US",
            "telephone_number": "651-220-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGER",
        "first_name": "JENNIFER",
        "middle_name": "NOEL",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IA",
            "license": "DO-04888",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "65386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.