Ida M Bergstrom, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0071811 Issued in MD

Practice address

5425 Wisconsin Ave Ste 810
Chevy Chase, MD 20815-3552

Phone

(202) 266-7070

Fax

(202) 266-7073

NPI assigned

Feb 25, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 22, 2016 through Jun 22, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: ida.bergstrom.1@28513.direct.athenahealth.com

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1366611352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 WISCONSIN AVE STE 810",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153552",
            "telephone_number": "202-266-7070",
            "fax_number": "202-266-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 WISCONSIN AVE STE 810",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153552",
            "telephone_number": "202-266-7070",
            "fax_number": "202-266-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "IDA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD30754",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0071811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine S Bennet
• Benthal Medical
• Jenna N Benyounes, CNM
• Brenda Jean Berberian, MD
• Sarah Shafer Berger, PH.D.
• Daniel M Berinstein, M.D.
• David K Berler, MD
• Steven Howard Bernstein Jr., M.D.
• Edward W Bernton, M.D.
• Bethesda Chevy Chase Dental Care

• Internal Medicine Physician in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.