Elyssa Berg, - Medicare Emergency Medicine in Fort Defiance, AZ

Elyssa Berg, is a medicare enrolled "Emergency Medicine" physician in Fort Defiance, Arizona. She went to Yale University School Of Medicine and graduated in 2014 and has 10 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice The Fort Defiance Indian Hospital Board, Incorporation and her current practice location is Corner Of Route N12 And N7, Fort Defiance, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 729-8600.

Elyssa Berg is licensed to practice in Michigan (license number 4301113504) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1255745113.

Contact Information

Elyssa Berg,
Corner Of Route N12 And N7,
Fort Defiance, AZ 86504
(928) 729-8600
Not Available



Physician's Profile

Full NameElyssa Berg
GenderFemale
SpecialityEmergency Medicine
Experience10 Years
LocationCorner Of Route N12 And N7, Fort Defiance, Arizona
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Elyssa Berg attended and graduated from Yale University School Of Medicine in 2014
  NPI Data:
  • NPI Number: 1255745113
  • Provider Enumeration Date: 06/18/2014
  • Last Update Date: 05/24/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 6406153097
  • Enrollment ID: I20171016001728

Medical Identifiers

Medical identifiers for Elyssa Berg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255745113NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 4301113504 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Fort Defiance Indian HospitalFort defiance, AZHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
The Fort Defiance Indian Hospital Board, Incorporation0941336697144

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Elyssa Berg allows following entities to bill medicare on her behalf.
Entity NameThe Fort Defiance Indian Hospital Board, Incorporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477876639
PECOS PAC ID: 0941336697
Enrollment ID: O20100429001153

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elyssa Berg is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Elyssa Berg,
Po Box 589,
Fort Defiance, AZ 86504-0589

Ph: (928) 792-8600
Elyssa Berg,
Corner Of Route N12 And N7,
Fort Defiance, AZ 86504

Ph: (928) 729-8600

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Emergency Medicine Doctors in Fort Defiance, AZ

Dr. Romulo Laureta Parungao, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504
Phone: 928-729-8600    
Dr. Tyrone Harold Walker, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: Corner Of Rte N 12 And N 7, Fort Defiance, AZ 86504
Phone: 928-729-8600    
Dr. Brian Ezar Cooper, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: Corner Of Rt N7 And N12, Fort Defiance, AZ 86504
Phone: 928-729-8600    Fax: 928-729-8624
Samuel Bryan Wood,
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504
Phone: 928-729-8600    
Dr. Scott A Kelso, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504
Phone: 928-729-8000    
Dr. Shannon Reynolds, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504
Phone: 928-729-8132    

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