Active NPI
Carley Jeanne Berthiaume, PA-C
- Physician Assistant
- Bloomington, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13710
- Practice address
- 4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435 - Phone
- (952) 835-9880
- Fax
- (952) 857-1554
- NPI assigned
- Jun 24, 2021
- 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 | 13710 | MN | Primary |
Addresses
Primary practice location
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Mailing address
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone (952) 835-9880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1159 County Rd E E
Vadnais Heights, MN 55110-5183
Phone (651) 789-6500
3010 Denmark Ave
Eagan, MN 55121-2271
Phone (651) 789-9900
4300 Marketpointe Dr
Suite 100
Bloomington, MN 55435-5435
Phone (952) 835-9880
6110 Golden Hills Dr
Golden Valley, MN 55416-1020
Phone (952) 835-9880
7115 Tamarack Rd
Suite 150
Woodbury, MN 55125-1208
Phone (651) 789-7000
Hospital & facility affiliations
- Abbott Northwestern Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 94.23
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13710 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physicians Professional Association | Current | Accepting new patients | |
| Emergency Physicians Professional Association | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Past | Accepting new patients |
Locations
4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Bloomington, MN
- NPI 1801871934
-
- Urgent Care Clinic/Center
- Golden Valley, MN
- NPI 1750188488
-
- Durable Medical Equipment & Medical Supplies
- River Falls, WI
- NPI 1144608589
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679356800000",
"number": "1891364600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 MARKETPOINTE DR STE 100",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554355435",
"telephone_number": "952-835-9880",
"fax_number": "952-857-1554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 MARKETPOINTE DR STE 100",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554355435",
"telephone_number": "952-835-9880",
"fax_number": "952-857-1554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTHIAUME",
"first_name": "CARLEY",
"middle_name": "JEANNE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-24",
"last_updated": "2023-03-21",
"certification_date": "2023-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "13710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.