Kendra Gail Bergstrom, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD60117060 Issued in WA

Practice address

4225 Roosevelt Way NE FL 4
Seattle, WA 98105-6099

Phone

(206) 598-4067

NPI assigned

Jun 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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.

Enrollment records 1

Specialty

Dermatology

Education

Stanford University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as apm

Quality

74.6

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbergstrom307746@direct.ehre.uwmedicine.org

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.

• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159

  Dermatology

  Medicare reassignment Care Compare group NPD
• Orbuch, Brand Dermatology Associates LLP

  • MOHS-Micrographic Surgery Physician
  • Bethpage, NY
  • NPI 1992785117

  Dermatology

  NPD (past)

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

• University of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194764837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5546 CANFIELD PL N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035920",
            "telephone_number": "917-596-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 ROOSEVELT WAY NE FL 4",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056099",
            "telephone_number": "206-598-4067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8435 SE 68th St",
            "address_2": "Suite 118",
            "address_purpose": "LOCATION",
            "city": "Mercer Island",
            "state": "WA",
            "postal_code": "980405249",
            "country_code": "US",
            "telephone_number": "206-232-7546",
            "fax_number": "206-275-0805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "KENDRA",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "238443",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD60117060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl E. Bergsagel, MS
• Shannon Bergstedt
• Carson Josef Bergstrom
• Eric John Bergstrom, O.D.
• Katie Lee Bergstrom, MS, CGC
• Nicole Bergstrom
• Ruth A. Berhane, RDH
• Biniam Berhe
• Freedom Zerasenai Berhe
• Yonas Berhe

• Dermatology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.