Individual provider Active NPI

Kurt Bergeron

  • Physical Therapist
  • Amherst, NH
National Provider Identifier
1053428573
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2757 Issued in NH
Practice address
282 State Route 101
Unit 11
Amherst, NH 03031-1706
Phone
(603) 372-5125
Fax
(603) 372-5126
NPI assigned
Aug 23, 2006
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2757 NH Primary

Addresses

Primary practice location

282 State Route 101
Unit 11
Amherst, NH 03031-1706

Mailing address

73 Newton Rd
Ste 101
Plaistow, NH 03865-2424
Phone (978) 388-7272

Other identifiers 1

IdentifierTypeStateIssuer
000184301OtherNHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000417 NH Practitioner - Physical Therapist in Private Practice 2668564998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

282 Route 101
Unit 4
Amherst, NH 03031-1706
Phone (603) 672-5125

50 Bridge St
Suite 200
Manchester, NH 03101-1630
Phone (603) 665-9222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2757NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Rehabilitation Network LLC Physical Therapist CurrentSince Jul 2, 2007 Accepting new patients
Pinnacle Rehabilitation Network, LLC Physical Therapist Current Accepting new patients
Pinnacle Rehabilitation Network, LLC Physical Therapist CurrentSince Jul 2, 2007 Accepting new patients
Pinnacle Rehabilitation Network, LLC Physical Therapist Past Accepting new patients

Locations

282 State Route 101
Unit 4
Amherst, NH 03031
Phone (603) 672-5125

50 Bridge St
Ste 200
Manchester, NH 03101
Phone (603) 665-9222

73 Newton Rd
Unit 101
Plaistow, NH 03865
Phone (978) 388-7272

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1053428573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 NEWTON RD",
            "address_2": "STE 101",
            "city": "PLAISTOW",
            "state": "NH",
            "postal_code": "038652424",
            "telephone_number": "978-388-7272",
            "fax_number": "978-388-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 STATE ROUTE 101",
            "address_2": "UNIT 11",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030311706",
            "telephone_number": "603-372-5125",
            "fax_number": "603-372-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "KURT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "2757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000184301",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.