Active NPI
Michelle M Berlin, P.A.C.
- Physician Assistant
- Bellevue, NE
National Provider Identifier
1700099736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 733
- Practice address
- 2206 Longo Dr Ste 107
Bellevue, NE 68005-2977 - Phone
- (402) 734-4106
- Fax
- (402) 734-0366
- NPI assigned
- May 7, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 733 | NE | Primary |
Addresses
Primary practice location
2206 Longo Dr Ste 107
Bellevue, NE 68005-2977
Mailing address
2206 Longo Dr Ste 107
Bellevue, NE 68005-2977
Phone (402) 734-4106
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 733 | Other | NE | NE PHYSICAN ASST. LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 733 | NE | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellevue Obstetrics and Gynecology Associates PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- Bellevue, NE
- NPI 1245274802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700099736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2206 LONGO DR STE 107",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "680052977",
"telephone_number": "402-734-4106",
"fax_number": "402-734-0366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2206 LONGO DR STE 107",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "680052977",
"telephone_number": "402-734-4106",
"fax_number": "402-734-0366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLIN",
"first_name": "MICHELLE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "P.A.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "733",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NE PHYSICAN ASST. LICENSE",
"identifier": "733",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.