Individual provider Active NPI

Jeanelyn Berges, PA-C

  • Physician Assistant
  • Boynton Beach, FL
National Provider Identifier
1861426611
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102518 Issued in FL
Practice address
9897 Hagen Ranch Rd
Boynton Beach, FL 33472-7400
Phone
(561) 364-7774
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9102518 FL Primary

Addresses

Primary practice location

9897 Hagen Ranch Rd
Boynton Beach, FL 33472-7400

Mailing address

1700 W Woolbright Rd
Boynton Beach, FL 33426-6346
Phone (561) 364-7774

Other practice location 1

1401 N Federal Hwy
Boca Raton, FL 33432-1925
Phone (561) 955-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070314000172 FL Practitioner - Physician Assistant 1052317609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siperstein Dermatology Group PLLCGroup PAC ID 3476683145, 18 clinicians

Practice addresses (Care Compare)

950 Glades Rd
FL 4
Boca Raton, FL 33431-6401
Phone 5619558885327

9897 Hagen Ranch Rd
Boynton Beach, FL 33437-6700

Merit-based Incentive Payment System (MIPS)

Final score
91.82 of 100Reported as group
Quality
93.58
Promoting interoperability
100
Improvement activities
40
Cost
79.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9102518FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Dermatology LLC PastSince Oct 4, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1861426611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W WOOLBRIGHT RD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266346",
            "telephone_number": "561-364-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9897 HAGEN RANCH RD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334727400",
            "telephone_number": "561-364-7774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 N Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334321925",
            "country_code": "US",
            "telephone_number": "561-955-8885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGES",
        "first_name": "JEANELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.