Michael A Bergeron, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

014330 Issued in ME

Practice address

74 Baribeau Dr
Brunswick, ME 04011-3218

Phone

(207) 777-4111

Fax

(207) 783-6660

NPI assigned

Jun 30, 2006

Last updated

Nov 7, 2016By the provider in NPPES

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 ME, NH2 enrollments

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 2

Specialty

Family Practice

Education

Geisel School of Medicine at Dartmouth, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derry Medical Center, PAGroup PAC ID 5294711768, 98 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4

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.

• Derry Medical Center, PA

  • Family Medicine Physician
  • Derry, NH
  • NPI 1922030493
  Medicare reassignment Care Compare group NPD
• Martin's Point Health Care, Inc.

  • Family Medicine Physician
  • Portland, ME
  • NPI 1366474611
  Medicare reassignment NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1225067663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 BARIBEAU DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113218",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BARIBEAU DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113218",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "014330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Beltramini, FNP
• Christine Bender, D.O.
• Lyn A Benton, O.D.
• Hillary Jackson Benuck, DPT
• Molly Joann Berberich, LMSW-CC
• David Ringvik Bergman
• Yonca Berk-Giray
• Kylie Nicole Berry, PT
• Laura Bell Bertulli, LCSW
• Richard Beveridge, M.D.

• Family Medicine Physician in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.