Individual provider Active NPI

Lloyd Stuart Berg, PHD

  • Psychologist
  • Austin, TX
National Provider Identifier
1548295785
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
25608 Issued in TX
Practice address
3501 Mills Ave
Austin, TX 78731-6309
Phone
(512) 324-2000
NPI assigned
Jul 12, 2006
Last updated
Dec 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 25608 TX Primary

Addresses

Primary practice location

3501 Mills Ave
Austin, TX 78731-6309

Mailing address

1601 Rio Grande St Ste 340
Austin, TX 78701-1162
Phone (512) 795-5500

Other identifiers 3

IdentifierTypeStateIssuer
079974401MedicaidTX
096603804MedicaidTX
88061AOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019001432 TX Practitioner - Clinical Psychologist 0345138756 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-County ClinicalGroup PAC ID 1153502869, 27 clinicians

Practice addresses (Care Compare)

3501 Mills Ave Seton Shoal Creek
Austin, TX 78731-6309
Phone (512) 324-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.35 of 100Reported as group
Quality
76.32
Improvement activities
40
Cost
74.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
25608TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas at Austin Dell Medical School CurrentSince Nov 15, 2018 Accepting new patients
University of Texas at Austin Dell Medical School CurrentSince Nov 15, 2018 Accepting new patients

Locations

1601 Trinity St
Austin, TX 78712
Phone (833) 882-2737

Interoperability endpoints

  • Direct secure messaging: lloyd.berg.1@16041.direct.athenahealth.com
  • Direct secure messaging: lloyd.berg.1@8363.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1548295785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 RIO GRANDE ST STE 340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011162",
            "telephone_number": "512-795-5500",
            "fax_number": "512-795-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 MILLS AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316309",
            "telephone_number": "512-324-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "LLOYD",
        "middle_name": "STUART",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "25608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079974401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096603804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88061A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.