NPIMap

Individual provider Active NPI

Richard Walter Bergstrom, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Portland, OR
National Provider Identifier
1326196841
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD16439 Issued in OR
Practice address
9135 SW Barnes Rd Ste 985
Portland, OR 97225-6699
Phone
(503) 297-3336
Fax
(503) 297-3338
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD16439 OR Primary

Addresses

Primary practice location

9135 SW Barnes Rd Ste 985
Portland, OR 97225-6699

Mailing address

9135 SW Barnes Rd Ste 985
Portland, OR 97225-6699
Phone (503) 297-3336

Other identifiers 1

IdentifierTypeStateIssuer
003736MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100223000819 OR Practitioner - Endocrinology 4880776764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Washington School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Diabetes and EndocrinologyGroup PAC ID 1557358769, 10 clinicians

Practice addresses (Care Compare)

9135 SW Barnes Rd
Suite 985
Portland, OR 97225-6699
Phone (503) 297-3336

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

Merit-based Incentive Payment System (MIPS)

Final score
67.76 of 100Reported as group
Quality
37.65
Improvement activities
40
Cost
75.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16439ORMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Diabetes & Endocrinology Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 1966 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9135 SW Barnes Rd
Ste 985
Portland, OR 97225
Phone (503) 297-3336

1130 NW 22nd Ave
Ste 400
Portland, OR 97210
Phone (503) 413-6555

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73586

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 10

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1326196841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 985",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256699",
            "telephone_number": "503-297-3336",
            "fax_number": "503-297-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 985",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256699",
            "telephone_number": "503-297-3336",
            "fax_number": "503-297-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "RICHARD",
        "middle_name": "WALTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OR",
            "license": "MD16439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003736",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.