Brian Scott Bergstrom, DO, MA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5942 Issued in OK

Practice address

101 S Moore Ave
Claremore, OK 74017-5047

Phone

(918) 342-6200

NPI assigned

Feb 21, 2015

Last updated

Jul 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Arts

Interoperability endpoints

• Direct secure messaging: bbergstrom714777@directa.mercy.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1033501531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13006 E 112TH ST N",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556220",
            "telephone_number": "913-674-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MOORE AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175047",
            "telephone_number": "918-342-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DO, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-21",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "5942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Bence, PHARM. D.
• Kalee Lyn Benedict
• Jared Lee Bennett, RPH
• Jennifer Bennett, D. PH.
• Ruth Hanna Benson
• Tommye Berry, MHR, CMII
• Yalonda Berry
• Edwina Rae Berryhill
• Samuel Isaac Bethea, PA-C
• Aaron Eleazar Biddlecombe

• Surgery Physician in Claremore, OK
• Providers in Claremore, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.