Carl Ronald Berg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00578 Issued in TX

Practice address

605 Old Austin Hwy
Bastrop, TX 78602

Phone

(877) 800-5722

Fax

(512) 332-2180

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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.

• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1891746970

  TX

  Medicare reassignment
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1710581145
  NPD

Medicare fee-for-service enrollment

Enrolled in TX, OK2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carl.berg.1@9763.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 24, 2026.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1659396398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266814",
            "telephone_number": "512-686-0207",
            "fax_number": "512-869-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OLD AUSTIN HWY",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "78602",
            "telephone_number": "877-800-5722",
            "fax_number": "512-332-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "CARL",
        "middle_name": "RONALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00578",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00578",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1819898-02",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carlronald.berg.p1@direct.lscctx.nextgenshare.com",
            "affiliation": "N",
            "address_1": "605 Old Austin Hwy",
            "city": "Bastrop",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bastrop Open MRI L L P Partnership
• Augustin Roger Batlle, MD
• Lance A Beahm, PA-C
• Aime Geelyn Begay, APRN-CNP
• Thelma Bell-Punchard, LPC
• Meghan Bhakta, DDS
• Kimberly Renee Bilal, NP
• Bio-Medical Applications of Texas, Inc.
• Sarah Blair, FNP
• Lorna Casey Blakney, APRN-FNP BC

• All providers in Bastrop, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.