NPIMap

Individual provider Active NPI

Heidi A Berdin, MD

  • Pulmonary Disease Physician
  • Lake Havasu City, AZ
National Provider Identifier
1659368751
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
42565 Issued in AZ
Practice address
1830 Mesquite Ave
Suite C
Lake Havasu City, AZ 86403-5885
Phone
(928) 855-6966
Fax
(928) 855-6974
NPI assigned
Oct 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 42565 AZ Primary

Addresses

Primary practice location

1830 Mesquite Ave
Suite C
Lake Havasu City, AZ 86403-5885

Mailing address

PO Box 650
Lake Havasu City, AZ 86405-0650
Phone (928) 855-6966

Other identifiers 1

IdentifierTypeStateIssuer
479811MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000434 AZ Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 8224044540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease, Sleep Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1830 Mesquite Ave
Suite C
Lake Havasu City, AZ 86403-5885
Phone (928) 855-6966

Hospital & facility affiliations

  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
  • La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317
  • Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055
  • Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101

Merit-based Incentive Payment System (MIPS)

Final score
90.89 of 100Reported as individual
Quality
96.63
Improvement activities
40
Cost
70.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42565AZMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Inc CurrentSince Jul 3, 2013 Accepting new patients
Apogee Medical Group Inc CurrentSince Jul 3, 2013 Accepting new patients
Medical Rehabilitation Associates, Inc PC Past Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEEIAA/Endpoint/DEEIAA
  • Direct secure messaging: owz9235@yourcarecommunity.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1659368751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864050650",
            "telephone_number": "928-855-6966",
            "fax_number": "928-855-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 MESQUITE AVE",
            "address_2": "SUITE C",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035885",
            "telephone_number": "928-855-6966",
            "fax_number": "928-855-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDIN",
        "first_name": "HEIDI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "42565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479811",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.