Michelle Elizabeth Bergen, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95007057 Issued in CA

Practice address

1275 E Spruce Ave Ste 101
Fresno, CA 93720-3372

Phone

(559) 439-5757

Fax

(559) 437-3943

NPI assigned

Oct 31, 2017

Sex

Female

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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.bergen@562886312394756.direct.elationemr.com

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.

• Premier Cancer Care and Infusion Center

  • Hematology & Oncology Physician
  • Fresno, CA
  • NPI 1568190064
  Medicare reassignment NPD
• Premier Cancer Care and Infusion Center

  • Non-Pharmacy Dispensing Site
  • Fresno, CA
  • NPI 1740051978
  NPD

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1144732017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 E SPRUCE AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203372",
            "telephone_number": "559-439-5757",
            "fax_number": "559-437-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 E SPRUCE AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203372",
            "telephone_number": "559-439-5757",
            "fax_number": "559-437-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "MICHELLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95007057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kori Elizabeth Berg, PHARMD, BCPS
• Ryan A Berg, M.D.
• Shohini C Berg
• David M Bergdahl, M.D.
• Kathleen Ruth Bergen, LMFT
• Carly Ann Berger
• Caitlyn Bergeron
• Chet Berglund
• Cynthia Ann Bergmann, MD
• Virginia Bergstrom, LMFT

• Primary Care Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.

Verify at the official NPI Registry.