Individual provider Active NPI

Amy Berghoff, PA-C

  • Medical Physician Assistant
  • Munster, IN
National Provider Identifier
1144617663
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10001814A Issued in IN
Practice address
9900 Columbia Ave
Munster, IN 46321-4008
Phone
(219) 924-3300
Fax
(219) 934-2658
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10001814A IN
Medical Physician Assistant 363AM0700X 10001814A IN Primary

Addresses

Primary practice location

9900 Columbia Ave
Munster, IN 46321-4008

Mailing address

PO Box 3329
Munster, IN 46321-0329
Phone (219) 924-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aberghoff@OSNWI1911.srs-direct.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150507000229 IN Practitioner - Physician Assistant 5294054607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Specialists of Northwest Indiana PCGroup PAC ID 5092788901, 18 clinicians

Practice addresses (Care Compare)

10200 Wicker Ave
1 Osni St John
Saint John, IN 46373-9439
Phone (219) 924-3300

730 45TH Ave
Munster, IN 46321-2818

730 45TH St
Munster, IN 46321-2818
Phone 2199243300150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10001814AINMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: aberghoff204152@direct.franciscanalliance.org
  • Direct secure messaging: aberghoff@osnwi1911.srs-direct.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1144617663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3329",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463210329",
            "telephone_number": "219-924-3300",
            "fax_number": "219-934-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214008",
            "telephone_number": "219-924-3300",
            "fax_number": "219-934-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGHOFF",
        "first_name": "AMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10001814A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001814A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aberghoff@OSNWI1911.srs-direct.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "730 45th Ave",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463212818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.