Kristin Marie Berka, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103380 Issued in NC

Practice address

15830 Ballantyne Medical PL Ste 100
Charlotte, NC 28277-0762

Phone

(704) 341-0090

NPI assigned

Mar 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Care of Charlotte PAGroup PAC ID 7911906151, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dermatology Care of Charlotte, PA

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1639195126
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1609837814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 HEALTHCARE DRIVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323858",
            "telephone_number": "803-329-6030",
            "fax_number": "803-329-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15830 BALLANTYNE MEDICAL PL STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770762",
            "telephone_number": "704-341-0090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1563 Healthcare Drive",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297323858",
            "country_code": "US",
            "telephone_number": "803-329-6030",
            "fax_number": "803-329-6035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERKA",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1109",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103380",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "85246",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7985246",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Bergman
• Anne Parker Bergwall, MD
• Mary Kay Berhalter
• Lia Berhane, RPH
• Vanessa Leigh Berich, PA-C
• Rachel Bethany Berlin, NP
• Susan Marie Berlin, R.PH.
• Adam M Berliner, DO
• Donald P. Berling, MD
• Kevin Louis Berman

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.