NPIMap

Individual provider Active NPI

Alec Bergman, PA-C

  • Physician Assistant
  • Frankenmuth, MI
National Provider Identifier
1063920049
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5315089920 Issued in MI
Practice address
1027 W Genesee St
Frankenmuth, MI 48734-1302
Phone
(989) 652-5210
Fax
(989) 652-3741
NPI assigned
Jan 12, 2018
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5315089920 MI Primary

Addresses

Primary practice location

1027 W Genesee St
Frankenmuth, MI 48734-1302

Mailing address

PO Box 779
Tawas City, MI 48764-0779
Phone (989) 652-5210

Other practice location 1

800 S Washington Ave
Saginaw, MI 48601-2551
Phone (989) 907-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alecbergman@smomsjhs.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180327000248 MI Practitioner - Physician Assistant 1254693542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center SaginawGroup PAC ID 6305737156, 111 clinicians
Rau Physical Therapy IncGroup PAC ID 2365721339, 98 clinicians

Practice addresses (Care Compare)

1027 W Genesee St
Frankenmuth, MI 48734-1302
Phone (989) 652-5224

193 E Jefferson St
Frankenmuth, MI 48734-1935

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5315089920MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Saginaw CurrentSince Apr 1, 2020 Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Apr 1, 2020 Accepting new patients
Mymichigan Medical Center Saginaw Past Accepting new patients

Locations

1027 W Genesee St
Frankenmuth, MI 48734
Phone (989) 652-5210

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000

Interoperability endpoints

  • Direct secure messaging: alec.bergman.1@11016.direct.athenahealth.com

Organizations & group practices 6

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 2

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1063920049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487640779",
            "telephone_number": "989-652-5210",
            "fax_number": "989-652-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 W GENESEE ST",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341302",
            "telephone_number": "989-652-5210",
            "fax_number": "989-652-3741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486012551",
            "country_code": "US",
            "telephone_number": "989-907-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "ALEC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-12",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5315089920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alecbergman@smomsjhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1027 W Genesee St",
            "city": "Frankenmuth",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487341302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Frankenmuth, MI

Sources for this page

Verify at the official NPI Registry.