ELYSSA BERG
NPI 1255745113
Emergency Medicine in Fort Defiance, AZ
About Elyssa Berg NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELYSSA BERG (NPI 1255745113) is an individual emergency medicine provider in Fort Defiance, Arizona, licensed in Michigan (4301113504) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS and is a graduate of Yale University School Of Medicine (2014).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Elyssa Berg is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Elyssa Berg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Defiance, AZ 86504
- Reassigned Medicare billing, Texas enrollment
- 518 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 86504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT DEFIANCE, AZ 86504
FORT DEFIANCE, AZ 86504
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Elyssa Berg's NPI number?
The NPI number for Elyssa Berg is 1255745113. It was assigned to this individual provider in the NPPES registry on June 18, 2014.
Where is Elyssa Berg located?
Elyssa Berg practices at Corner Of Route N12 And N7, Fort Defiance, AZ 86504. The listed phone number is (928) 729-8000.
What is Elyssa Berg's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Elyssa Berg enrolled in Medicare?
Yes. Elyssa Berg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Elyssa Berg's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elyssa Berg reassigns Medicare benefits to The Fort Defiance Indian Hospital Board, Incorporation (Fort Defiance, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elyssa Berg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Elyssa Berg was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Elyssa Berg · NPI 1255745113
Emergency Medicine physician in Fort Defiance, Arizona. Individual provider, active in the CMS NPPES registry since June 18, 2014.
## Identity
- **NPI:** 1255745113 (Entity type: Individual)
- **Enumerated:** June 18, 2014
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 4301113504 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** CORNER OF ROUTE N12 AND N7, Fort Defiance, AZ 86504
- **Phone:** (928) 729-8000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** The Fort Defiance Indian Hospital Board, Incorporation (NPI 1477876639, Fort Defiance, AZ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Yale University School Of Medicine, class of 2014
## Record status
- **NPPES last updated:** August 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1255745113) · Data from the CMS NPPES public registry.