Active NPI
Bergen Iris Kassoff, PA-C
- Physician Assistant
- Washington, DC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA200001820
- Practice address
- 106 Irving St NW Ste 216
Washington, DC 20010-2993 - Phone
- (301) 742-6051
- NPI assigned
- Apr 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0009332 | MD | |
| Physician Assistant | 363A00000X | PA200001820 | DC | Primary |
Addresses
Primary practice location
106 Irving St NW Ste 216
Washington, DC 20010-2993
Mailing address
106 Irving St NW Ste 216
Washington, DC 20010-2993
Phone (301) 742-6051
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401
12158 Central Ave
Mitchellville, MD 20721-1932
Phone (301) 430-2750
Hospital & facility affiliations
- Medstar Washington Hospital Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA200001820 | DC | MD | Physician Assistant |
| C0009332 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current | Accepting new patients |
Locations
3007 Tilden St NW
Ste 5N
Washington, DC 20008
106 Irving St NW
Ste 216
Washington, DC 20010
Phone (202) 877-5840
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
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.
-
- Internal Medicine Physician
- Washington, DC
- NPI 1376887844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Washington, DC
- NPI 1548378235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1295420875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 IRVING ST NW STE 216",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102993",
"telephone_number": "301-742-6051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 IRVING ST NW STE 216",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102993",
"telephone_number": "301-742-6051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASSOFF",
"first_name": "BERGEN",
"middle_name": "IRIS",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-10",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0009332",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "DC",
"license": "PA200001820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.