Individual provider Active NPI

Hunter Bergamasco

  • Perfusionist
  • Redwood City, CA
National Provider Identifier
1285013284
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PerfusionistTaxonomy code 242T00000X
License
D04742501 Issued in AZ
Practice address
710 Bair Island Rd Apt 401
Redwood City, CA 94063-5550
Phone
(650) 321-9999
NPI assigned
May 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perfusionist 242T00000X D04742501 AZ Primary

Addresses

Primary practice location

710 Bair Island Rd Apt 401
Redwood City, CA 94063-5550

Mailing address

PO Box 27573
San Francisco, CA 94127-0573
Phone (650) 321-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D04742501AZMDPerfusionist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Life Lines, Inc. Perfusionist Past Accepting new patients
Pacific Life Lines, Inc Perfusionist Past Accepting new patients

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": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1285013284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27573",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941270573",
            "telephone_number": "650-321-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 BAIR ISLAND RD APT 401",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940635550",
            "telephone_number": "650-321-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGAMASCO",
        "first_name": "HUNTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "AZ",
            "license": "D04742501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.