Active NPI
Jeffrey Aric Bergsman, MD
- Geriatric Medicine (Internal Medicine) Physician
- Kailua Kona, HI
National Provider Identifier
1083664064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- MD10538
- 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
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130503000570 | FL | Order and Referring Only - Internal Medicine | 1052558350 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD10538 | HI | MD | Geriatric Medicine (Internal Medicine) Physician |
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | MD10538 | HI | Primary |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | ME77724 | FL |
Addresses
NPPES NPI RegistryPrimary 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.