Individual provider Active NPI

Amber Berg, O.T.R./L.

  • Occupational Therapist
  • Duluth, MN
National Provider Identifier
1194821157
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
102903 Issued in MN
Practice address
1000 E 1St St
Suite 404
Duluth, MN 55805-2297
Phone
(218) 625-1884
Fax
(218) 722-6515
NPI assigned
Sep 16, 2006
Last updated
Aug 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 102903 MN Primary

Addresses

Primary practice location

1000 E 1St St
Suite 404
Duluth, MN 55805-2297

Mailing address

1000 E 1St St
Suite 404
Duluth, MN 55805-2297
Phone (218) 625-1884

Other identifiers 4

IdentifierTypeStateIssuer
941498300MedicaidMN
106G2BEOtherMNBCBS MN INDIVIDUAL
6404781OtherMNMN MEDICA INDIVIDUAL
40882400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000501 MN Practitioner - Occupational Therapist in Private Practice 3476501909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Associates of Duluth PAGroup PAC ID 1951294065, 37 clinicians

Practice addresses (Care Compare)

1000 E 1St St
Suite 404
Duluth, MN 55805-2297
Phone (218) 722-5513

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Duluth, P.a. CurrentSince Mar 16, 2010 Accepting new patients
Northern Arm & Hand Center, Inc. Occupational Therapist Past Accepting new patients
Northern Arm & Hand Center, Inc. Past Accepting new patients

Locations

1000 E 1st St
Ste 400
Duluth, MN 55805
Phone (218) 625-2728

1000 E 1st St
Ste 404
Duluth, MN 55805
Phone (218) 722-5513

1420 London Rd
Ste 102
Duluth, MN 55805
Phone (218) 728-3774

4310 Menard Dr
Ste 400
Hermantown, MN 55811
Phone (218) 625-2727

Organizations & group practices 3

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": "1313625600000",
    "number": "1194821157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST",
            "address_2": "SUITE 404",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-625-1884",
            "fax_number": "218-722-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST",
            "address_2": "SUITE 404",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-625-1884",
            "fax_number": "218-722-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "AMBER",
        "credential": "O.T.R./L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "102903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941498300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN INDIVIDUAL",
            "identifier": "106G2BE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICA INDIVIDUAL",
            "identifier": "6404781",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40882400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.