Mark E Berntson, MD
Individual provider Active NPI Family Medicine Physician · Brezzy Point, MN
NPI 1508807116 · NPPES record last updated Dec 13, 2019
Key facts
- NPI
- 1508807116
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 31661 (MN)
- Practice address
- 30833 North Star Dr. Ste 1
Brezzy Point, MN 56472-4407 - Phone
- (218) 568-4926
- Fax
- (218) 546-4400
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Dakota School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Bismarck
Practice addresses (Care Compare)
3318 N 14TH St
Bismarck, ND 58503-1614
Phone (701) 323-8300
565 S 7TH St
Bismarck, ND 58504-5859
Phone (701) 323-5550
Hospital & facility affiliations
- Sanford Medical Center Bismarck
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041215000063 | MN | Practitioner - Family Practice | 4385601020 | Reassigns benefits to 2 organizations |
| I20041228000873 | ND | Practitioner - Family Practice | 4385601020 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5350 | ND | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Region Healthcare Corporation | Current |
Accepting new patients | |
| Lake Region Healthcare Corporation | Current |
Accepting new patients | |
| Unity Family Healthcare | Current | Accepting new patients | |
| Unity Family Healthcare | Current |
Accepting new patients | |
| Sanford Bismarck | Family Medicine | Current |
Accepting new patients |
| Unity Family Healthcare | Current |
Accepting new patients |
Locations
7892 Solutions Ctr
Chicago, IL 60677
712 S Cascade St
Fergus Falls, MN 56537
815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441
811 2nd St SE
Little Falls, MN 56345
Phone (320) 631-7000
3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300
2603 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5222
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5350 | ND | |
| Family Medicine Physician | 207Q00000X | 31661 | MN | Yes |
Addresses
Primary practice location
30833 North Star Dr. Ste 1
Brezzy Point, MN 56472-4407
Mailing address
320 East Main Street
Crosby, MN 56441
Phone (218) 546-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500M5BE | Other | MN | BCBS |
| 15352 | Medicaid | ND | |
| 666588800 | Medicaid | MN |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2019. 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.
- Order and Referring (CMS).
- 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.