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Kristin Marie Berka

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

15830 Ballantyne Medical Pl Ste 100, Charlotte, NC 28277-0762

PECOS Enrollment

This provider is enrolled in PECOS as KRISTIN BERKA.

Based on the most recent information from CMS, provider Kristin Marie Berka is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1609837814
Provider Type
Individual
Full Name
Berka, Kristin Marie
Title
Ms.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/29/2006
Last Updated
10/8/2020

Contact Information

Practice Location

15830 Ballantyne Medical Pl Ste 100, Charlotte, NC 28277-0762

(704) 341-0090

Unlisted Fax

Mailing Location

1563 Healthcare Drive, Rock Hill, SC 29732-3858

(803) 329-6030

(803) 329-6035

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 103380 North Carolina
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 1109 South Carolina
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 103380 North Carolina

Provider Identifiers

ID	Description	Issuer
ID 85246	Description Other	Issuer BLUECROSS BLUESHIELD North Carolina
ID 7985246	Description Medicaid	Issuer Unlisted North Carolina

Kristin Marie Berka

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

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Provider Identifiers

ID

Description

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ID

Description

Issuer

ID

Description

Issuer

Rodriguez, Mariah Leigh

Leyrer, Jacqueline Ellen

Nielsen, Alicia Konneker

Griffin, Noelle A

Whitman, Kyle Phillip

Mcmasters, Joy Elaine

Kinzel, Alexandria Nicole

Kauer, Lauren Steele

Buery, Amy Suzanne

Sullins, Alyssa Leigh