Dianne Ranae Berg, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4299 Issued in MN

Practice address

1300 S 2ND St
Suite 180
Minneapolis, MN 55454-1075

Phone

(612) 625-1500

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.63 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment Care Compare group NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1821173329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3989 CENTRAL AVE NE",
            "address_2": "SUITE 180",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554213900",
            "telephone_number": "612-625-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S 2ND ST",
            "address_2": "SUITE 180",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541075",
            "telephone_number": "612-625-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "DIANNE",
        "middle_name": "RANAE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4299",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4299",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT 0487",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "984151027400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307193600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP48975",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Edward Berg
• Allison Berg, MS, CGC
• Amanda Elizabeth Berg, MSW, LICSW
• Amber Berg III
• Brian Berg, M.D.
• Estee Berg, DPT
• Jenna Norene Berg
• Jennifer Lynn Berg, CRNA
• Kevin Anthony Berg, D.C.
• Krysta Berg, PA-C

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.

Verify at the official NPI Registry.