Anthony W Bergstrom, O. D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003314 Issued in WA

Practice address

136 NW 2ND St
Stevenson, WA 98648-4225

Phone

(509) 427-2020

Fax

(509) 427-8268

NPI assigned

Nov 13, 2006

Last updated

Aug 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stevenson Family Eye Care

  • Optometrist
  • Stevenson, WA
  • NPI 1548692437
  Medicare reassignment NPD Authorized official
• Baldwin Family Enterprises PLLC

  dba White Salmon Eyecare

  • Eyewear Supplier
  • White Salmon, WA
  • NPI 1952821654

  Optometrist

  NPD (past)
• Bergstrom Family Eyecare P S

  • Eyewear Supplier
  • White Salmon, WA
  • NPI 1184795684
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1306917356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "STEVENSON",
            "state": "WA",
            "postal_code": "986480378",
            "telephone_number": "509-427-2020",
            "fax_number": "509-427-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 NW 2ND ST",
            "city": "STEVENSON",
            "state": "WA",
            "postal_code": "986484225",
            "telephone_number": "509-427-2020",
            "fax_number": "509-427-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "ANTHONY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022325",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Aris, PT
• Melissa Rose Bernt, LMP
• Spencer Lee Bolles
• Sharon Gay Bonge, CDP
• Betsy Borchgrevink, OT/L, CHT
• Rian Ashlee Brown

• Optometrist in Stevenson, WA
• Providers in Stevenson, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.