Individual provider Active NPI

Caylen Nicole Berg

  • Speech-Language Pathologist
  • Waukesha, WI
National Provider Identifier
1467240416
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528846 Issued in MN
Practice address
N14W23800 Stone Ridge Dr Ste 110
Waukesha, WI 53188-1144
Phone
(262) 696-5325
NPI assigned
Apr 29, 2025
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 528846 MN Primary

Addresses

Primary practice location

N14W23800 Stone Ridge Dr Ste 110
Waukesha, WI 53188-1144

Mailing address

600 Uptown Blvd
Brookfield, WI 53045-1366
Phone (262) 442-9471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023001449 WI Practitioner - Qualified Speech Language Pathologist 3870081680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

725 American Ave
Waukesha, WI 53188-5099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
528846MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Oct 1, 2025 Accepting new patients
Capernaum Pediatric Therapy, Inc. CurrentSince May 4, 2025 Accepting new patients
Prohealth Medical Group Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

6625 Lyndale Ave S
Ste 430
Richfield, MN 55423
Phone (952) 285-2840

N14W23800 Stone Ridge Dr
Ste 110
Waukesha, WI 53188
Phone (262) 696-5325

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

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": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1467240416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 UPTOWN BLVD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530451366",
            "telephone_number": "262-442-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23800 STONE RIDGE DR STE 110",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881144",
            "telephone_number": "262-696-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "CAYLEN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.