Individual provider Active NPI

Barbara Bergeski, P.A.

  • Physician Assistant
  • Livonia, MI
National Provider Identifier
1295705382
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002728 Issued in MI
Practice address
17800 Newburgh Rd
Suite 103
Livonia, MI 48152-2700
Phone
(734) 464-9540
Fax
(734) 464-0438
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002728 MI Primary

Addresses

Primary practice location

17800 Newburgh Rd
Suite 103
Livonia, MI 48152-2700

Mailing address

17800 Newburgh Rd
Suite 103
Livonia, MI 48152-2700
Phone (734) 266-2780

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060615000120 MI Practitioner - Physician Assistant 8921010869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers Eastern Michigan PCGroup PAC ID 9234480575, 63 clinicians

Practice addresses (Care Compare)

17800 Newburgh Rd
103 Livonia Family Physicians
Livonia, MI 48152-2794
Phone (734) 464-9540

39475 Lewis Dr
Novi, MI 48377-2977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601002728MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Medical Group PLLC Physician Assistant CurrentSince Jun 1, 2010 Accepting new patients
Envision Medical Group PLLC CurrentSince Jun 1, 2010 Accepting new patients
Livonia Family Physicians, PC Physician Assistant Past Accepting new patients
Livonia Family Physicians, PC Past Accepting new patients

Locations

17800 Newburgh Rd
Ste 103
Livonia, MI 48152
Phone (734) 464-9540

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

39475 Lewis Dr
Ste 130
Novi, MI 48377
Phone (248) 374-0502

Interoperability endpoints

  • Direct secure messaging: barbara.bergeski.1@21803.direct.athenahealth.com

Organizations & group practices 5

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295705382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 NEWBURGH RD",
            "address_2": "SUITE 103",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522700",
            "telephone_number": "734-266-2780",
            "fax_number": "734-466-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 NEWBURGH RD",
            "address_2": "SUITE 103",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522700",
            "telephone_number": "734-464-9540",
            "fax_number": "734-464-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGESKI",
        "first_name": "BARBARA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.