Michael A Berg, MS
Individual provider Active NPI Audiologist · Fargo, ND
NPI 1396763025 · NPPES record last updated Feb 2, 2012
Key facts
- NPI
- 1396763025
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 437 (ND)
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-2441
- Fax
- (701) 234-2606
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Qualified Audiologist
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000
Hospital & facility affiliations
- Sanford Medical Center Fargo
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110411000196 | ND | Practitioner - Qualified Audiologist | 9133303571 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 437 | ND | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Current |
Accepting new patients |
Locations
801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 437 | ND | Yes |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2441
NPI Registry JSON
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328140800000",
"number": "1396763025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-2441",
"fax_number": "701-234-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-2441",
"fax_number": "701-234-2606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "MICHAEL",
"middle_name": "A",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2012-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "ND",
"license": "437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2012. 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.
- 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.