Mary Lynn Berntson, OTRL CHT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

25 Issued in ND

Practice address

3035 Demers Ave
Grand Forks, ND 58201-4040

Phone

(701) 746-7521

NPI assigned

Jan 19, 2006

Last updated

Jul 1, 2024By the provider in NPPES

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 10

Other names 1

• Miss Mary Lynn Florence Former name

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Enrollment records 2

Specialty

Occupational Therapist in Private Practice

Education

University of North Dakota School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Achieve Therapy LLC

  dba Achieve Therapy

  • Physical Therapist
  • Grand Forks, ND
  • NPI 1013009232
  Medicare reassignment NPD
• Achieve Therapy LLC

  dba Achieve Therapy of Park Rapids

  • Physical Therapist
  • East Grand Forks, MN
  • NPI 1407919210
  Medicare reassignment NPD
• Achieve Therapy LLC

  • Physical Therapist
  • Park River, ND
  • NPI 1063850436
  NPD
• Axis Clinic PC

  • Occupational Therapist
  • Grand Forks, ND
  • NPI 1518905512
  NPD
• Sanford Medical Center Fargo

  dba Sanford Health Enderlin Clinic

  • Rural Health Clinic/Center
  • Enderlin, ND
  • NPI 1285666271
  NPD
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD
• Sanford Medical Center Fargo

  • Air Ambulance
  • Fargo, ND
  • NPI 1942415468
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1639159338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "701-732-2947",
            "fax_number": "701-732-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014040",
            "telephone_number": "701-746-7521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 44th Ave S",
            "address_2": "Unit 120D",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582013434",
            "country_code": "US",
            "telephone_number": "701-732-2947",
            "fax_number": "701-732-2945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNTSON",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTRL CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "100966",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": "AA522599",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54901",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "201942600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2605838",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1042277",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND",
            "identifier": "24561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN MUTUAL",
            "identifier": "24561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEMERS LOCATION",
            "identifier": "24780",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "341M0BE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "64-05705",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP62219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FLORENCE",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tricia Berg
• Chantel Bergquist
• Jaxon Bergum
• Irene J Berndt, LICSW
• Lisa Michelle Bernhardt, AGNP
• Caitlin Marie Bero
• Justin W Berry, PT DPT
• Autumn Bertch
• Caitlin Bertsch
• Zane Besler, OD

• Occupational Therapist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.