Denise C Klubertanz-Berge, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8454 Issued in WI

Practice address

3925 N Gateway Dr
Appleton, WI 54913-7863

Phone

(920) 779-7953

NPI assigned

Nov 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Denise C Berge Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dklubertanzberge59432@direct.myadvocateaurora.org
• Direct secure messaging: dklubertanzberge181756@direct.thedacare.org

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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1508379405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-779-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N GATEWAY DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137863",
            "telephone_number": "920-779-7953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1881 Chicago St",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "54115",
            "country_code": "US",
            "telephone_number": "920-403-8000",
            "fax_number": "920-830-5910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549118735",
            "country_code": "US",
            "telephone_number": "920-779-7953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLUBERTANZ-BERGE",
        "first_name": "DENISE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8454",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100078250",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dklubertanzberge59432@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1881 Chicago St",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1881 Chicago St",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "BERGE",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.