NPIMap

Individual provider Active NPI

Chris Sheldon Bergstrom, M.D.

  • Ophthalmology Physician
  • Atlanta, GA
National Provider Identifier
1346273596
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
53097 Issued in GA
Practice address
1365 Clifton Rd NE # B
Atlanta, GA 30322-1013
Phone
(404) 778-4176
Fax
(404) 778-4380
NPI assigned
Jul 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 53097 GA Primary

Addresses

Primary practice location

1365 Clifton Rd NE # B
Atlanta, GA 30322-1013

Mailing address

3050 Wembley Forest CT
Atlanta, GA 30340-4712
Phone (770) 496-0611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20160415000357 SC Practitioner - Ophthalmology 5890734065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Kansas School of Med (KC/Wich/Sal), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Consultants of Carolina, PAGroup PAC ID 2163559477, 11 clinicians

Practice addresses (Care Compare)

1126 Grove Rd
Greenville, SC 29605-4620
Phone (864) 233-5722

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53097GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Consultants of Carolina, PA Ophthalmology CurrentSince May 1, 2016 Accepting new patients

Locations

1655 E Greenville St
Anderson, SC 29621
Phone (803) 224-6375

1126 Grove Rd
Greenville, SC 29605
Phone (864) 233-5722

Organizations & group practices 1

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.

Hospital & facility affiliations 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346273596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 WEMBLEY FOREST CT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303404712",
            "telephone_number": "770-496-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE # B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-4176",
            "fax_number": "404-778-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "CHRIS",
        "middle_name": "SHELDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "53097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.