Individual provider Active NPI

Ashley C Berger, PA-C

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1699217463
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9113389 Issued in FL
Practice address
5742 Booth Rd Ste a
Jacksonville, FL 32207-5982
Phone
(904) 739-7779
Fax
(904) 739-7771
NPI assigned
Nov 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA058493 PA
Medical Physician Assistant 363AM0700X PA9113389 FL Primary

Addresses

Primary practice location

5742 Booth Rd Ste a
Jacksonville, FL 32207-5982

Mailing address

7015 A C Skinner Pkwy Ste 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113

Other identifiers 3

IdentifierTypeStateIssuer
108131500MedicaidFL
M3030OtherFLMEDICARE
LY69VOtherFLFL BLUE

Other names 1

  • Ashley C Moyer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 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
I20170130001264 PA Practitioner - Physician Assistant 8426330390 Reassigns benefits to 1 organization
I20200929000229 FL Practitioner - Physician Assistant 8426330390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113389FLMDMedical Physician Assistant
MA058493PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Nov 13, 2016 Accepting new patients
University of Pittsburgh Physicians CurrentSince Nov 13, 2016 Accepting new patients
Cancer Specialists, LLC CurrentSince Sep 24, 2020 Accepting new patients
Cancer Specialists, LLC CurrentSince Sep 24, 2020 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

5742 Booth Rd
Ste A
Jacksonville, FL 32207
Phone (904) 739-7779

7015 A C Skinner Pkwy
Ste 1
Jacksonville, FL 32256
Phone (904) 363-2113

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

5115 Centre Ave
Fl 2
Pittsburgh, PA 15232
Phone (412) 623-3395

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.

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1699217463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-363-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5742 BOOTH RD STE A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075982",
            "telephone_number": "904-739-7779",
            "fax_number": "904-739-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "ASHLEY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058493",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9113389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108131500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M3030",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "LY69V",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MOYER",
            "middle_name": "C",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.