Individual provider Active NPI

Yvonne Bergeon Brewer, MPT

  • Physical Therapist
  • Aliso Viejo, CA
National Provider Identifier
1295729804
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25894 Issued in CA
Practice address
27432 Aliso Creek Rd
Ste 100
Aliso Viejo, CA 92656-5337
Phone
(949) 448-0872
Fax
(949) 448-0984
NPI assigned
Sep 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25894 CA Primary

Addresses

Primary practice location

27432 Aliso Creek Rd
Ste 100
Aliso Viejo, CA 92656-5337

Mailing address

27432 Aliso Creek Rd
Ste 100
Aliso Viejo, CA 92656-5337
Phone (949) 448-0872

Other names 1

  • Yvonne Marie Bergeon Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040120001097 CA Practitioner - Physical Therapist in Private Practice 5991606089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cowell Health Services IncGroup PAC ID 3971724600, 4 clinicians

Practice addresses (Care Compare)

27432 Aliso Creek Rd
Suite 100
Aliso Viejo, CA 92656-5337

27432 Aliso Creek Rd
Suite 100
Aliso Viejo, CA 92656-5384
Phone (949) 448-0984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT25894CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cowell Health Services, Inc. CurrentSince Sep 12, 2016 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist Past Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist PastSince Jul 1, 1999 Accepting new patients
Bodyworkspt, Inc. PastSince Jan 1, 2019 Accepting new patients

Locations

27432 Aliso Creek Rd
Ste 100
Aliso Viejo, CA 92656
Phone (949) 448-0872

Organizations & group practices 4

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1295729804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27432 ALISO CREEK RD",
            "address_2": "STE 100",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565337",
            "telephone_number": "949-448-0872",
            "fax_number": "949-448-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27432 ALISO CREEK RD",
            "address_2": "STE 100",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565337",
            "telephone_number": "949-448-0872",
            "fax_number": "949-448-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "YVONNE",
        "middle_name": "BERGEON",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YVONNE",
            "last_name": "BERGEON",
            "middle_name": "MARIE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.