Individual provider Active NPI

Heather Marie Bergstrom Falendysz, D.O.

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1316200124
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60409594 Issued in WA
Practice address
1115 SE 164TH Ave Dept 358
Vancouver, WA 98683-8004
Phone
(360) 735-8100
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OL60288895 WA
Family Medicine Physician 207Q00000X OP60409594 WA Primary

Addresses

Primary practice location

1115 SE 164TH Ave Dept 358
Vancouver, WA 98683-8004

Mailing address

1115 SE 164TH Ave Dept 358
Vancouver, WA 98683-8004
Phone (360) 735-8100

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151112000674 WA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 9133342207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OL60288895WAMDFamily Medicine Physician
OP60409594WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Sep 8, 2015 Accepting new patients
Peacehealth Family Medicine Past Accepting new patients

Locations

505 NE 87th Ave
Ste 260
Vancouver, WA 98664
Phone (360) 514-6450

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

16811 SE McGillivray Blvd
Vancouver, WA 98683
Phone (360) 514-4900

Interoperability endpoints

  • Direct secure messaging: hbergstromfalendysz72292@direct.peacehealth.org

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1316200124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-735-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-735-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM FALENDYSZ",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL60288895",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60409594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.