Emily Bergeron, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

321252 Issued in LA

Practice address

820 Jordan St Ste 201
Shreveport, LA 71101-4518

Phone

(318) 221-0399

Fax

(318) 221-1940

NPI assigned

Oct 30, 2019

Last updated

Oct 30, 2019By the provider in NPPES

Sex

Female

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 LA

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Musculoskeletal Institute of Louisiana LLCGroup PAC ID 0143127415, 28 clinicians

Larry K. Broadwell, M.D., a Medical CorporationGroup PAC ID 7113984402, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Specialists Hospital Shreveport Hospital, Shreveport, LA, CCN 190278
• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/BAJHBA

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.

• Musculoskeletal Institute of Louisiana, L.L.C.

  • Orthopaedic Surgery Physician
  • Shreveport, LA
  • NPI 1316957012

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Rheumatology and Osteoporosis Specialists, AMC

  • Rheumatology Physician
  • Shreveport, LA
  • NPI 1689766271
  Medicare reassignment Care Compare group
• Musculoskeletal Institute of Louisiana, LLC

  • Orthopaedic Surgery Physician
  • Bossier City, LA
  • NPI 1265616130
  NPD
• Rheumatology and Osteoporosis Specialists, AMC

  dba Rheumatology and Osteoporosis Specialists Pharmacy

  • Pharmacy
  • Shreveport, LA
  • NPI 1477343713
  NPD

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

• Specialists Hospital Shreveport, LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912118134
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba Christus St. Michael Health System

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba CHRISTUS St. Michael Health System

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1295379576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 JORDAN ST STE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014518",
            "telephone_number": "318-221-0399",
            "fax_number": "318-221-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 JORDAN ST STE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014518",
            "telephone_number": "318-221-0399",
            "fax_number": "318-221-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "321252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maitreyee Berends
• Jack L. Berg, MD
• Mary Ellen Berg, M.D.
• Mollie Berg, PA-C
• Amanda Berger
• Natalie Berlin, LPC
• Amanda Bernard
• Brennan Anthony Bernard
• Thomas Jeffrey Bernard, M.D.
• Edward Glenn Bernatowicz, RPH

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.