Individual provider Active NPI

Jason H Berg, APNP-BC

  • Nurse Practitioner
  • Eau Claire, WI
National Provider Identifier
1992080246
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4658-33 Issued in WI
Practice address
1400 Bellinger St
Eau Claire, WI 54703
Phone
(715) 838-5222
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4658-33 WI
Nurse Practitioner 363L00000X 4658-33 WI Primary

Addresses

Primary practice location

1400 Bellinger St
Eau Claire, WI 54703

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (715) 838-5222

Other practice location 1

1200 OakLeaf Way
Suite A
Altoona, WI 54720-2245
Phone (715) 832-1400

Other practice location 2

1200 OakLeaf Way
Suite A
Altoona, WI 54720-2245
Phone (715) 832-1400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jberg32267@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20121112000605 WI Practitioner - Nurse Practitioner 0941458392 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4658WIMDSpeech-Language Pathologist
4658-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jul 24, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jul 24, 2017 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

1501 Thompson St
Bloomer, WI 54724
Phone (715) 568-2000

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

13025 8th St
Osseo, WI 54758
Phone (715) 597-2575

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1992080246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54703",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 OakLeaf Way",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "WI",
            "postal_code": "547202245",
            "country_code": "US",
            "telephone_number": "715-832-1400",
            "fax_number": "715-832-4187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 OakLeaf Way",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "WI",
            "postal_code": "547202245",
            "country_code": "US",
            "telephone_number": "715-832-1400",
            "fax_number": "715-832-4187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "JASON",
        "middle_name": "H",
        "credential": "APNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4658-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4658-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jberg32267@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Bellinger St",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.