Colin Oliver Bergeron, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3014 Issued in OK

Practice address

6161 S Yale Ave
Tulsa, OK 74136-1992

Phone

(918) 502-3939

Fax

(918) 502-3945

NPI assigned

Mar 25, 2019

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 OK

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ies ER Oklahoma LLCGroup PAC ID 5395234678, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Ies ER Oklahoma LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1447148093
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Physicians of Tulsa County, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1003098773
  Medicare reassignment NPD
• Usacs Observation Medicine Services of Oklahoma, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1326739111
  Medicare reassignment NPD
• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment NPD
• Jane Phillips Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Bartlesville, OK
  • NPI 1215914254
  NPD (past)

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

• Jane Phillips Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Bartlesville, OK
  • NPI 1215914254
  Care Compare affiliation
• Jane Phillips Memorial Medical Center, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Bartlesville, OK
  • NPI 1427428986
  Care Compare affiliation

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1174083018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361992",
            "telephone_number": "918-502-3939",
            "fax_number": "918-502-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361992",
            "telephone_number": "918-502-3939",
            "fax_number": "918-502-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "COLIN",
        "middle_name": "OLIVER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Berg, PHD
• Stacy Ann Berg, LPC
• Molly T Berger, MACCC/SLP
• Sheldon Curtis Berger, D.O.
• Brittany Bergeron, B.S
• Emily Montana Bergeron, PHYSICIAN ASSISTANT
• Mary Gale Berghaus, DC
• Taylor Berghoff
• Bergman Chiropractic
• Brooke Nicole Bergman, DO

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.