Kristen Michelle Bergemann, PA
Individual provider Active NPI Physician Assistant · Niagara Falls, NY
NPI 1346692282 · NPPES record last updated Jan 24, 2017
Key facts
- NPI
- 1346692282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 019795 (NY)
- Practice address
- 621 10TH St
Niagara Falls, NY 14301-1813 - Phone
- (716) 278-4395
- NPI assigned
- Jul 4, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Delphi Healthcare PLLC
Practice addresses (Care Compare)
845 Routes 5 and 20
Irving, NY 14081-9706
Phone (716) 951-7000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160902001294 | NY | Practitioner - Physician Assistant | 2769778562 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 019795 | NY | Yes |
Addresses
Primary practice location
621 10TH St
Niagara Falls, NY 14301-1813
Mailing address
621 10TH St
Niagara Falls, NY 14301-1813
Other providers in Niagara Falls, NY
- Michael S. Beecher
- Christian Marshall Bell
- Heather L Bennett
- Linda Benson
- Bensons Surgical and DME Supply LLC
- Alicia M. Berk
- Rose-Danielle Bertresse
- Jennifer C Besecker
- Elizabeth Anne Best
- Saveda A Beswick
All providers in Niagara Falls, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.