Active NPI
Bethany Berg
- Physician Assistant
- Omaha, NE
National Provider Identifier
1780007799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1786
- Practice address
- 4350 Dewey Ave
Omaha, NE 68105-1017 - Phone
- (402) 552-6007
- NPI assigned
- Jan 27, 2014
- 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 | 1786 | NE | Primary |
Addresses
Primary practice location
4350 Dewey Ave
Omaha, NE 68105-1017
Mailing address
4350 Dewey Ave
Omaha, NE 68105-1017
Phone (402) 552-6007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 096742004 | Other | NE | MEDICARE ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Nebraska College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
42 ND Dewey St
Unmc Physicians Dewey Ave
Omaha, NE 68198-1023
Phone (402) 552-6007
Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Physician Assistant
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Omaha, NE
- NPI 1417912114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1780007799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4350 DEWEY AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051017",
"telephone_number": "402-552-6007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 DEWEY AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051017",
"telephone_number": "402-552-6007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "BETHANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-27",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "1786",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "096742004",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.