NPIMap

Individual provider Active NPI

John D Bergren, MD

  • Family Medicine Physician
  • Scotts Valley, CA
National Provider Identifier
1023110301
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G79510 Issued in CA
Practice address
245 Mount Hermon Rd Ste L
Scotts Valley, CA 95066-4044
Phone
(831) 430-7203
Fax
(831) 430-7204
NPI assigned
Sep 5, 2006
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4035 AK
Family Medicine Physician 207Q00000X G79510 CA Primary

Addresses

Primary practice location

245 Mount Hermon Rd Ste L
Scotts Valley, CA 95066-4044

Mailing address

245 Mount Hermon Rd Ste L
Scotts Valley, CA 95066-4044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121203000198 CA Practitioner - Family Practice 2961695069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1595 Soquel Dr
Santa Cruz, CA 95065-1724

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Nov 5, 2012 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Nov 5, 2012 Accepting new patients
Sequoia Health Services Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Santa Cruz Community Health Centers Family Medicine Past Accepting new patients

Locations

13350 Highway 236
Boulder Creek, CA 95006
Phone (831) 338-6491

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

223 Mount Hermon Rd
Ste A
Scotts Valley, CA 95066
Phone (831) 426-7585

245 Mount Hermon Rd
Ste L
Scotts Valley, CA 95066
Phone (831) 430-7203

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1023110301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MOUNT HERMON RD STE L",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MOUNT HERMON RD STE L",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664044",
            "telephone_number": "831-430-7203",
            "fax_number": "831-430-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGREN",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4035",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G79510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotts Valley, CA

Sources for this page

Verify at the official NPI Registry.