Active NPI
Tina Marie Berg, M.A., CCC-A
- Audiologist
- Lewistown, MT
National Provider Identifier
1407906381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU1068
- Practice address
- 625 NE Main St
Suite 1
Lewistown, MT 59457-2084 - Phone
- (406) 538-5072
- Fax
- (406) 538-5059
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU1068 | MT | Primary |
Addresses
Primary practice location
625 NE Main St
Suite 1
Lewistown, MT 59457-2084
Mailing address
625 NE Main St
Suite 1
Lewistown, MT 59457-2084
Phone (406) 538-5072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT, TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040901000851 | MT | Practitioner - Qualified Audiologist | 7012982077 | Reassigns benefits to 1 organization |
| I20140718001512 | TX | Practitioner - Qualified Audiologist | 7012982077 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
625 NE Main St
Lewistown, MT 59457-2084
Phone (406) 538-5072
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU1068 | MT | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| US Dept of HHS | Current | Accepting new patients | |
| U S Health Dept of Health & Human Services | Current | Accepting new patients | |
| Central Montana Hearing & Audiology, P.C. | Audiologist | Current | Accepting new patients |
| US Health Dept of Health & Human Services | Current | Accepting new patients |
Locations
669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100
625 NE Main St
Ste 1
Lewistown, MT 59457
Phone (406) 538-5072
Organizations & group practices 4
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.
-
- Hearing and Speech Clinic/Center
- Lewistown, MT
- NPI 1447491287
Audiologist, MT
-
- Critical Access Hospital
- Lodge Grass, MT
- NPI 1750410395
-
- Clinic/Center
- Lame Deer, MT
- NPI 1053487991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407906381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 NE MAIN ST",
"address_2": "SUITE 1",
"city": "LEWISTOWN",
"state": "MT",
"postal_code": "594572084",
"telephone_number": "406-538-5072",
"fax_number": "406-538-5059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 NE MAIN ST",
"address_2": "SUITE 1",
"city": "LEWISTOWN",
"state": "MT",
"postal_code": "594572084",
"telephone_number": "406-538-5072",
"fax_number": "406-538-5059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "TINA",
"middle_name": "MARIE",
"credential": "M.A., CCC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MT",
"license": "AU1068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lewistown, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.