Jenna Marie Bergmark, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300176 Issued in CA

Practice address

137 S Las Posas Rd Ste 254
San Marcos, CA 92078-2475

Phone

(760) 290-3121

Fax

(760) 290-3126

NPI assigned

Jul 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nexus Physical TherapyGroup PAC ID 6305890609, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Nexus Physical Therapy

  • Physical Therapist
  • Elcajon, CA
  • NPI 1952461741
  Medicare reassignment Care Compare group NPD
• MKC Physical Therapy Inc

  • Physical Therapist
  • El Cajon, CA
  • NPI 1609117829
  Medicare reassignment NPD

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1376115774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 S LAS POSAS RD STE 254",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782475",
            "telephone_number": "760-290-3121",
            "fax_number": "760-290-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 S LAS POSAS RD STE 254",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782475",
            "telephone_number": "760-290-3121",
            "fax_number": "760-290-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMARK",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Richmond Bennett, M.D.
• Jessica Bentley
• Glory Benz
• Sheena Marie Bergeron
• Haley Bergman
• Connor Anthony Berk, LMFT
• Alan L Berkowitz, MD
• Damaris Bernal
• Alethea Anne Bernstein, M.D.
• Donna Lee Bernstein, MS, LCGC

• Physical Therapist in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.