Emily Montana Bergeron, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1417 W 78TH St Apt 1213
Tulsa, OK 74132-4633

Phone

(918) 955-9302

NPI assigned

Oct 8, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ies ER Oklahoma LLCGroup PAC ID 5395234678, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

Merit-based Incentive Payment System (MIPS)

Final score

93.51 of 100Reported as group

Quality

84.87

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ies ER Oklahoma LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1447148093
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Physicians of Tulsa County, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1003098773
  Medicare reassignment NPD
• Usacs Observation Medicine Services of Oklahoma, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1326739111
  Medicare reassignment NPD

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

• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368
  Care Compare affiliation
• St John Medical Center Inc

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1578656161
  Care Compare affiliation

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1295376523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4337 E 57TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354237",
            "telephone_number": "918-955-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 W 78TH ST APT 1213",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741324633",
            "telephone_number": "918-955-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "EMILY",
        "middle_name": "MONTANA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "4722",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Ann Berg, LPC
• Molly T Berger, MACCC/SLP
• Sheldon Curtis Berger, D.O.
• Brittany Bergeron, B.S
• Colin Oliver Bergeron, PA-C
• Mary Gale Berghaus, DC
• Taylor Berghoff
• Bergman Chiropractic
• Brooke Nicole Bergman, DO
• Jonathan Kyle Bergman, D.C.

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.