Marie Susan Bergomi, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.12705-NP Issued in OH

Practice address

2500 Metrohealth Dr
MHMC - Otolaryngology
Cleveland, OH 44109-1900

Phone

(216) 778-5790

Fax

(216) 778-2338

NPI assigned

Nov 2, 2011

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score

89.77 of 100Reported as group

Quality

91.47

Promoting interoperability

100

Improvement activities

40

Cost

74.42

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbergomi308597@direct.med.utah.edu

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.

• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment Care Compare group NPD
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment NPD
• University of Utah Adult Services

  • Hematology & Oncology Physician
  • Salt Lake City, UT
  • NPI 1205216264
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Riverton, UT
  • NPI 1043671985
  NPD
• University of Utah Pediatric Services

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD

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

• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1215213301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "address_2": "MHMC - OTOLARYNGOLOGY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-5790",
            "fax_number": "216-778-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "address_2": "MHMC - OTOLARYNGOLOGY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-5790",
            "fax_number": "216-778-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGOMI",
        "first_name": "MARIE",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.12705-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbergomi308597@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alf H Bergman, MD
• Kate Bergman, MSW
• Mark Bergman, MD
• Rachel Bergman, APRN
• Michel Paul Bergoeing Reid, M.D.
• Rose Anne Berila, PCNS
• Gail Beriswill, CNP
• Ali Berjaoui
• Alexander Nathan Berk, MD
• Susan H Berk, M.S.

• Family Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.
• 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.