Max Frederick Bergstrom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11420 Issued in NC

Practice address

354 Copperfield Blvd NE
Concord, NC 28025-2402

Phone

(704) 786-5122

Fax

(704) 782-8279

NPI assigned

Aug 13, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Duke Health Lake Norman Hospital Hospital, Mooresville, NC, CCN 340129
• Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orthocarolina

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1497704217
  Medicare reassignment Care Compare group
• Comprehab LLC

  • Physical Therapist
  • Gastonia, NC
  • NPI 1407932775
  Care Compare group
• Orthocarolina

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1104843978

  Physician Assistant

  NPD (past)

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

• Duke Health Lake Norman Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Mooresville, NC
  • NPI 1114731064
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Concord, NC
  • NPI 1487866315
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866
  Care Compare affiliation

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1104591874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2918",
            "fax_number": "704-945-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 COPPERFIELD BLVD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252402",
            "telephone_number": "704-786-5122",
            "fax_number": "704-782-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "MAX",
        "middle_name": "FREDERICK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-13",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A Beresh, CRNA
• Kevin Christopher Berg Jr.
• Rachel Marie Berg
• Sandy Yuen Shan Bergeron, RPH
• Ally Marie Bergman
• Gail Bernal, FNP-BC
• Cynthia Valderrey Bernett, M.S., CCC-SLP
• Alexandra Damerau Best, DMD, MSD, PA
• Damion Bethea
• Better Wellness Chiropractic Center, PLLC

• Physician Assistant in Concord, NC
• Providers in Concord, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.
• 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.