Individual provider Active NPI

Meaghan Moriah Berglund, PA

  • Physician Assistant
  • Rocklin, CA
National Provider Identifier
1235207143
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17248 Issued in CA
Practice address
4990 Rocklin Rd
#100
Rocklin, CA 95677-4315
Phone
(916) 788-4484
Fax
(916) 218-6252
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17248 CA Primary

Addresses

Primary practice location

4990 Rocklin Rd
#100
Rocklin, CA 95677-4315

Mailing address

4990 Rocklin Rd
#100
Rocklin, CA 95677-4315
Phone (916) 788-4484

Other names 1

  • Meaghan Moriah Baacke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040322001042 CA Practitioner - Physician Assistant 4789575630 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17248CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern California Neurological Surgeons Past Accepting new patients
Cobb French & Prasad Neurosurgical Associates a Medical Corporation PastSince Feb 26, 2009 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: meaghan.berglund.1@19187.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1235207143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4990 ROCKLIN RD",
            "address_2": "#100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956774315",
            "telephone_number": "916-788-4484",
            "fax_number": "916-218-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 ROCKLIN RD",
            "address_2": "#100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956774315",
            "telephone_number": "916-788-4484",
            "fax_number": "916-218-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLUND",
        "first_name": "MEAGHAN",
        "middle_name": "MORIAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGHAN",
            "last_name": "BAACKE",
            "middle_name": "MORIAH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rocklin, CA

Sources for this page

Verify at the official NPI Registry.