Individual provider Active NPI

Bethany Bergamo, M.D.

  • Dermatology Physician
  • Hickory, NC
National Provider Identifier
1265452023
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
200401471 Issued in NC
Practice address
1927 3Rd Avenue LN SE
Hickory, NC 28602-2960
Phone
(828) 328-3500
Fax
(828) 328-8777
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 200401471 NC Primary

Addresses

Primary practice location

1927 3Rd Avenue LN SE
Hickory, NC 28602-2960

Mailing address

315 19TH St SE
Hickory, NC 28602-4230
Phone (828) 325-9849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20050524001017 NC Practitioner - Dermatology 4688616295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Brody School of Medicine at East Carolina University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Plastic Surgery and Dermatology PAGroup PAC ID 6800875188, 56 clinicians

Practice addresses (Care Compare)

1927 3Rd Ave LN SE
Hickory, NC 28602-2960
Phone 7046711094101

959 Cox Rd
Gastonia, NC 28054-3420
Phone (704) 866-0106

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
91.92
Promoting interoperability
94
Improvement activities
40
Cost
78.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1445
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200401471NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Plastic Surgery & Dermatology PA Dermatology CurrentSince Jun 1, 2009 Accepting new patients
Piedmont Plastic Surgery and Dermatology Dermatology PastSince Jun 28, 2020 Accepting new patients

Locations

1072 X Ray Dr
Gastonia, NC 28054
Phone (704) 671-1094

959 Cox Rd
Gastonia, NC 28054
Phone (704) 866-0106

315 19th St SE
Bldg 200
Hickory, NC 28602

315 19th St SE
Hickory, NC 28602
Phone (828) 325-9849

1927 3rd Avenue Ln SE
Hickory, NC 28602
Phone (828) 328-3500

Interoperability endpoints

  • Direct secure messaging: bethany.bergamo.1@14667.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1265452023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 19TH ST SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024230",
            "telephone_number": "828-325-9849",
            "fax_number": "828-325-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 3RD AVENUE LN SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286022960",
            "telephone_number": "828-328-3500",
            "fax_number": "828-328-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGAMO",
        "first_name": "BETHANY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "200401471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.