Caitlyn Berg, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

125070674 Issued in IL

Practice address

441 W Hay St
Decatur, IL 62526-6324

Phone

(217) 545-8000

NPI assigned

Jun 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Caitlyn Berg Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: caitlynberg@siusm.allscriptsdirect.net

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.

• Siu Physicians & Surgeons, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment NPD
• Board of Trustees of Southern Illinois University

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Siu Physicians & Surgeons, Inc

  • Pediatrics Physician
  • Springfield, IL
  • NPI 1285657379
  NPD (past)

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1740710029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19635",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949635",
            "telephone_number": "217-545-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 W HAY ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266324",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "CAITLYN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125070674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLYN",
            "last_name": "BERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey Nicole Bell, APN, CRNA
• Agustin Bello, M.D.
• Morgan Belskamper
• Lee Larue Bennett, D.D.S
• Camille Grace Benning
• Kris Bernardin III
• Dante Alberto Betti, D.O.
• Jappan Bhatt, DO
• Huzefa Mustafa Bhopalwala, MD
• Faith Bibby, RBT

• Pediatrics Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.