MI JA KANG BERGERSON LICSW
NPI 1659086601
Social Worker - Clinical in Mound, MN
About Mi Ja Kang Bergerson Licsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MI JA KANG BERGERSON LICSW (NPI 1659086601) is an individual clinical provider in Mound, Minnesota, licensed in Minnesota (28770) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mi Ja Kang Bergerson Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mi Ja Bergerson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Minneapolis, MN 55408
- Reassigned Medicare billing, Minnesota enrollment
- 152 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55364 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Mi Ja Bergerson's NPI number?
The NPI number for Mi Ja Bergerson is 1659086601. It was assigned to this individual provider in the NPPES registry on January 13, 2023.
Where is Mi Ja Bergerson located?
Mi Ja Bergerson practices at 2385 Chateau Ln, Mound, MN 55364. The listed phone number is (612) 743-7893.
What is Mi Ja Bergerson's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Mi Ja Bergerson enrolled in Medicare?
Yes. Mi Ja Bergerson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mi Ja Bergerson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mi Ja Bergerson reassigns Medicare benefits to Lyn-Lake Psychotherapy And Wellness Ltd. (Minneapolis, MN). 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 Mi Ja Bergerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mi Ja Bergerson accept?
Health plans from HealthPartners list Mi Ja Bergerson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mi Ja Bergerson was last updated on January 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Mi Ja Kang Bergerson, LICSW · NPI 1659086601
Clinical provider in Mound, Minnesota. Individual provider, active in the CMS NPPES registry since January 13, 2023.
## Identity
- **NPI:** 1659086601 (Entity type: Individual)
- **Enumerated:** January 13, 2023
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 28770 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2385 CHATEAU LN, Mound, MN 55364-1750
- **Phone:** (612) 743-7893
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Lyn-Lake Psychotherapy And Wellness Ltd. (NPI 1609355163, Minneapolis, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** January 13, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1659086601) · Data from the CMS NPPES public registry.