NPIMap

Individual provider Active NPI

Andrew Bergersen, M.D.

  • Urology Physician
  • Robbinsdale, MN
National Provider Identifier
1063899250
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
66792 Issued in MN
Practice address
3366 Oakdale Ave N Ste 303
Robbinsdale, MN 55422-2977
Phone
(952) 927-6501
NPI assigned
Apr 27, 2015
Last updated
Jul 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R74933 AZ
Urology Physician 208800000X 66792 MN Primary

Addresses

Primary practice location

3366 Oakdale Ave N Ste 303
Robbinsdale, MN 55422-2977

Mailing address

2024 Georgia Ave S
Minneapolis, MN 55426-2841
Phone (602) 796-2868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20200513000120 MN Practitioner - Urology 4486960457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Arizona College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Urology, PAGroup PAC ID 0840183984, 83 clinicians

Practice addresses (Care Compare)

3366 Oakdale Ave N
Suite 303
Robbinsdale, MN 55422-2966
Phone (763) 520-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.79 of 100Reported as individual
Quality
77.8
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66792MNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Urology, PA Single Specialty CurrentSince Apr 8, 2020 Accepting new patients

Locations

6001 96th Ln N
Ste 250
Brooklyn Park, MN 55445

3366 Oakdale Ave N
Ste 303
Robbinsdale, MN 55422
Phone (763) 529-6454

360 Sherman St
Ste 450
Saint Paul, MN 55102
Phone (651) 641-7100

560 S Maple St
Ste 220
Waconia, MN 55387
Phone (952) 442-8011

6025 Lake Rd
Ste 200
Woodbury, MN 55125

Interoperability endpoints

  • Direct secure messaging: andrew.bergersen.1@20581.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20581/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1063899250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 GEORGIA AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554262841",
            "telephone_number": "602-796-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 303",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222977",
            "telephone_number": "952-927-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERSEN",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "R74933",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "66792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.