Active NPI
Molly Anne Berger, PA-C
- Physician Assistant
- Urbana, IL
National Provider Identifier
1669971115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085007016
- Practice address
- 611 W Park St
Urbana, IL 61801-2512 - Phone
- (217) 383-3364
- Fax
- (217) 383-4372
- NPI assigned
- Feb 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 090482 | IA | |
| Physician Assistant | 363A00000X | 085007016 | IL | Primary |
Addresses
Primary practice location
611 W Park St
Urbana, IL 61801-2512
Mailing address
611 W Park St
Urbana, IL 61801-2512
Phone (217) 383-3364
Other practice location 1
2815 Edgewood Rd SW
Cedar Rapids, IA 52404-3258
Phone (319) 396-9097
Other practice location 2
777 76th Avenue Dr SW
Cedar Rapids, IA 52404-7006
Phone (319) 558-0350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190614000509 | IL | Practitioner - Physician Assistant | 5193086429 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Carle Health Care Incorporated
Practice addresses (Care Compare)
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
- Carle Foundation Hospital
- Kirby Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090482 | IA | MD | Physician Assistant |
| 085007016 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Care Incorporated | Current | Accepting new patients | |
| Carle Health Care Incorporated | Past | Accepting new patients |
Locations
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- mbergerpa279866@carlehiedirect.net
Organizations & group practices 3
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.
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1235452996
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
Hospital & facility affiliations 4
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": "1518134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587340800000",
"number": "1669971115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012512",
"telephone_number": "217-383-3364",
"fax_number": "217-383-4372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012512",
"telephone_number": "217-383-3364",
"fax_number": "217-383-4372"
}
],
"practiceLocations": [
{
"address_1": "2815 Edgewood Rd SW",
"address_purpose": "LOCATION",
"city": "Cedar Rapids",
"state": "IA",
"postal_code": "524043258",
"country_code": "US",
"telephone_number": "319-396-9097",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "777 76th Avenue Dr SW",
"address_purpose": "LOCATION",
"city": "Cedar Rapids",
"state": "IA",
"postal_code": "524047006",
"country_code": "US",
"telephone_number": "319-558-0350",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERGER",
"first_name": "MOLLY",
"middle_name": "ANNE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-09",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "090482",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085007016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.