Individual provider Active NPI

Jeffrey Aric Bergsman, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Kailua Kona, HI
National Provider Identifier
1083664064
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD10538 Issued in HI
Practice address
75-5995 Kuakini Hwy
Kailua Kona, HI 96740-2144
Phone
(808) 329-0774
Fax
(808) 329-0776
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20130503000570 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1052558350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10538HIMDGeriatric Medicine (Internal Medicine) Physician

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD10538 HI Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME77724 FL

Addresses

NPPES NPI Registry

Primary practice location

75-5995 Kuakini Hwy
Kailua Kona, HI 96740-2144

Mailing address

76-715 Ahu St
Kailua Kona, HI 96740-2904
Phone (808) 331-0617

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083664064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76-715 AHU ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402904",
            "telephone_number": "808-331-0617",
            "fax_number": "808-329-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402144",
            "telephone_number": "808-329-0774",
            "fax_number": "808-329-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSMAN",
        "first_name": "JEFFREY",
        "middle_name": "ARIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "HI",
            "license": "MD10538",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME77724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.