Individual provider Active NPI

Joanne A Bergen, RPA-C

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1316976202
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003939 Issued in NY
Practice address
995 Senator Keating Blvd
Suite 200 Building E
Rochester, NY 14618-2775
Phone
(585) 244-8817
Fax
(585) 279-3612
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3939 NY
Physician Assistant 363A00000X 003939 NY Primary

Addresses

Primary practice location

995 Senator Keating Blvd
Suite 200 Building E
Rochester, NY 14618-2775

Mailing address

601 Elmwood Ave
Box 278980
Rochester, NY 14642-0001

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbergen32095@direct.urmc.rochester.edu Direct
Direct Messaging Address jbergen32095@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003939NYMDBehavioral Analyst
3939NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Mar 1, 2015 Accepting new patients
University of Rochester CurrentSince Mar 1, 2015 Accepting new patients

Locations

601 Elmwood Ave
#278980
Rochester, NY 14642
Phone (585) 768-2620

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#320
Rochester, NY 14642

995 Senator Keating Blvd
Ste 200
Rochester, NY 14618
Phone (585) 279-3600

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

Interoperability endpoints

  • Direct secure messaging: jbergen32095@direct.urmc.rochester.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1316976202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 278980",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 SENATOR KEATING BLVD",
            "address_2": "SUITE 200 BUILDING E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182775",
            "telephone_number": "585-244-8817",
            "fax_number": "585-279-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "JOANNE",
        "middle_name": "A",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "3939",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbergen32095@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbergen32095@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.