Jennifer Bergvall, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000957 Issued in VA

Practice address

5000 Bakers Mill LN Ste 170
Richmond, VA 23230-2432

Phone

(804) 359-0770

Fax

(804) 359-1106

NPI assigned

May 2, 2006

Last updated

May 17, 2022By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital Eye Care Doctors of Optometry PCGroup PAC ID 6406859164, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capital Eye Care, Doctors of Optometry, PC

  • Optometrist
  • Richmond, VA
  • NPI 1578592846
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1205894938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BAKERS MILL LN STE 170",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302432",
            "telephone_number": "804-359-0770",
            "fax_number": "804-359-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BAKERS MILL LN STE 170",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302432",
            "telephone_number": "804-359-0770",
            "fax_number": "804-359-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGVALL",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205894938",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Bereznicki
• Phyllis Ann Berg, PH.D.
• Daniel Julius Berger
• Brett Redmond Bergin, CPO
• Carl Johan Christian Bergman, M.D.
• Alem Berhane
• Jonathan David Berkman, M.D.
• Scott Berl
• Alice Joyce Berman, LPC
• Lisa Myra Berman, PHD

• Optometrist in Richmond, VA
• Providers in Richmond, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.