Individual provider Active NPI

Lisa Marie Berger, P.A.

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1497729172
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004069 Issued in MI
Practice address
145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2562
Phone
(616) 954-9800
Fax
(616) 954-1724
NPI assigned
Feb 17, 2006
Last updated
Mar 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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 5601004069 MI Primary

Addresses

Primary practice location

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2562

Mailing address

5800 Foremost Dr SE Ste 300
Grand Rapids, MI 49546-7062
Phone (616) 954-9800

Other names 1

  • Lisa Marie Duga Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040420000565 MI Practitioner - Physician Assistant 4183619984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2563
Phone (616) 954-9800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Apr 10, 2014 Accepting new patients
Inpatient Consultants of Michigan PC CurrentSince Nov 17, 2010 Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. Past Accepting new patients
Spectrum Health Hospitals Past Accepting new patients

Locations

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2373

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

145 Michigan St NE
Ste 3100
Grand Rapids, MI 49503
Phone (616) 954-9800

250 Cherry St SE
Ste 2200
Grand Rapids, MI 49503
Phone (616) 685-5600

3230 Eagle Park Dr NE
Grand Rapids, MI 49525
Phone (517) 324-3700

3230 Eagle Park Dr NE
Ste 101
Grand Rapids, MI 49525

5800 Foremost Dr SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 954-5554

5800 Foremost Dr SE
Ste 300
Grand Rapids, MI 49546
Phone (616) 389-1725

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1497729172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062",
            "telephone_number": "616-954-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE",
            "address_2": "SUITE 3100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032562",
            "telephone_number": "616-954-9800",
            "fax_number": "616-954-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DUGA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.