Elyssa Berg
Individual provider Active NPI Emergency Medicine Physician · Fort Defiance, AZ
NPI 1255745113 · NPPES record last updated Aug 11, 2026
Key facts
- NPI
- 1255745113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 4301113504 (MI)
- Practice address
- Corner of Route N12 and N7
Fort Defiance, AZ 86504 - Phone
- (928) 729-8000
- NPI assigned
- Jun 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Yale University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Fort Defiance Indian Hospital Board, Incorporation
Practice addresses (Care Compare)
Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082
Hospital & facility affiliations
- Fort Defiance Indian Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171016001728 | TX | Practitioner - Emergency Medicine | 6406153097 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Fort Defiance Indian Hospital Board, Incorporation | Current | Accepting new patients | |
| The Fort Defiance Indian Hospital Board, Incorporation | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4301113504 | MI | Yes |
Addresses
Primary practice location
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Mailing address
PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 792-8000
Other providers in Fort Defiance, AZ
- Natasha Begaye
- Iris Alexis Bekis
- Brenda J Benally
- Alana Marie Bencivengo
- Lydia Kaye Bennett
- Berhane Berhe
- Sarah Maria Berkenstock
- Denee Leigh Bex
- Sammie Micheal Bia III
- David Hale Bias
All providers in Fort Defiance, AZ · Emergency Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.