NPIMap

Individual provider Active NPI

Austin Charles Bergeron, PA-C

  • Surgical Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1235895194
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9115307 Issued in FL
Practice address
2320 NE 9TH St Ste 300
Fort Lauderdale, FL 33304-3590
Phone
(954) 563-4500
NPI assigned
Nov 15, 2021
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01644 RI
Surgical Physician Assistant 363AS0400X PA9115307 FL Primary
Plastic Surgery Physician 208200000X PA9115307 FL

Addresses

Primary practice location

2320 NE 9TH St Ste 300
Fort Lauderdale, FL 33304-3590

Mailing address

2320 NE 9TH St Ste 300
Fort Lauderdale, FL 33304-3590
Phone (954) 563-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240710003544 RI Practitioner - Physician Assistant 5799220158 Reassigns benefits to 1 organization
I20250819002245 FL Practitioner - Physician Assistant 5799220158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanguard Plastic Surgery PLLCGroup PAC ID 5193030252, 7 clinicians

Practice addresses (Care Compare)

2320 NE 9TH St
Suite 300
Fort Lauderdale, FL 33304-3579

2320 NE 9TH St
Suite 300
Fort Lauderdale, FL 33304-3590
Phone (954) 536-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urologic Specialists of New England LLC CurrentSince May 22, 2024 Accepting new patients
Michael C. Cheung, M.D., P.a. Plastic Surgery PastSince Aug 3, 2025 Accepting new patients

Locations

207 Quaker Ln
West Warwick, RI 02893
Phone (401) 275-8110

207 Quaker Ln
Fl 1
West Warwick, RI 02893
Phone (401) 828-7110

Interoperability endpoints

  • Direct secure messaging: austin.bergeron.1@29278.direct.athenahealth.com
  • Direct secure messaging: austin.bergeron@3844.securemail.prognocis.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1235895194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 NE 9TH ST STE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043590",
            "telephone_number": "954-563-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 NE 9TH ST STE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043590",
            "telephone_number": "954-563-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "AUSTIN",
        "middle_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01644",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9115307",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "PA9115307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.