Individual provider Active NPI

Kathryn Mary Berger

  • Physician Assistant
  • Cottage Grove, MN
National Provider Identifier
1609544717
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6936 Pine Arbor Dr S
Cottage Grove, MN 55016-4645
Phone
(651) 326-5800
NPI assigned
Sep 2, 2021
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

6936 Pine Arbor Dr S
Cottage Grove, MN 55016-4645

Mailing address

5816 Albright CT
Eau Claire, WI 54701-5045
Phone (920) 851-4302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20231101000576 MN Practitioner - Physician Assistant 3779939426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1700 University Ave W
Saint Paul, MN 55104-3727

6936 Pine Arbor Dr S
Suite 100
Cottage Grove, MN 55016-4661
Phone (651) 326-5800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Oct 13, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 13, 2023 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

6936 Pine Arbor Dr S
Cottage Grove, MN 55016
Phone (651) 326-5800

6936 Pine Arbor Dr S
Ste 100
Cottage Grove, MN 55016
Phone (651) 326-5800

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

Interoperability endpoints

  • Direct secure messaging: kberger714135@fairview.direct-ci.com

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 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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1609544717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 ALBRIGHT CT",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547015045",
            "telephone_number": "920-851-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6936 PINE ARBOR DR S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164645",
            "telephone_number": "651-326-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "KATHRYN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

Verify at the official NPI Registry.