Individual provider Active NPI

Carmel Berglin, P.A.

  • Surgical Physician Assistant
  • Dakota Dunes, SD
National Provider Identifier
1619971959
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0556 Issued in SD
Practice address
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone
(605) 217-2667
Fax
(605) 217-2900
NPI assigned
Jun 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0556 SD Primary

Addresses

Primary practice location

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312

Mailing address

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080107000295 TX Practitioner - Physician Assistant 7911990312 Reassigns benefits to 1 organization
I20241213001325 WY Practitioner - Physician Assistant 7911990312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Lincoln County Hospital DistrictGroup PAC ID 4789580218, 66 clinicians

Practice addresses (Care Compare)

10764 N US Hwy 30
Cokeville, WY 83114
Phone (307) 885-5970

110 Hospital LN
Afton, WY 83110-9409
Phone (307) 885-5852

120 Hospital LN
Afton, WY 83110-9409
Phone (307) 885-5870

195 Feather Way
Evanston, WY 82930-9352
Phone (307) 789-0096

901 Adams St
Afton, WY 83110-9621
Phone (307) 885-5800

904 Adams St
Afton, WY 83110-9621
Phone (307) 885-4873

Hospital & facility affiliations

  • Star Valley Medical Center Hospital, Afton, WY, CCN 531313

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
82.54
Promoting interoperability
89.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0556SDMDPhysical Therapy Assistant
00808KSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Lincoln County Hospital District CurrentSince Nov 29, 2024 Accepting new patients
Winnebago Tribe of Nebraska CurrentSince Mar 25, 2022 Accepting new patients
Winnebago Tribe of Nebraska CurrentSince Mar 25, 2022 Accepting new patients
North Lincoln County Hospital District CurrentSince Nov 29, 2024 Accepting new patients

Locations

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

225 Bluff St
Winnebago, NE 68071
Phone (402) 745-3950

106 Hospital Ln
Afton, WY 83110

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

110 Hospital Ln
Afton, WY 83110
Phone (208) 227-1137

195 Feather Way
Evanston, WY 82930
Phone (307) 200-9200

Organizations & group practices 6

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.

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1619971959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLIN",
        "first_name": "CARMEL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SD",
            "license": "0556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dakota Dunes, SD

Sources for this page

Verify at the official NPI Registry.