Individual provider Active NPI

Melissa Bergfeld, APRN

  • Women's Health Nurse Practitioner
  • Norwich, CT
National Provider Identifier
1376638858
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
003126 Issued in CT
Practice address
17 Case Street
Norwich, CT 06360
Phone
(860) 886-2461
Fax
(860) 887-8530
NPI assigned
Oct 3, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 003126 CT Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 003126 CT

Addresses

Primary practice location

17 Case Street
Norwich, CT 06360

Mailing address

17 Case Street
Norwich, CT 06360
Phone (860) 886-2461

Other identifiers 1

IdentifierTypeStateIssuer
004249307MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041122000484 CT Practitioner - Nurse Practitioner 4486619236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB-GYN Services, P.C.Group PAC ID 1850373077, 17 clinicians

Practice addresses (Care Compare)

17 Case St
Norwich, CT 06360-2208
Phone (860) 889-2909

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
003126CTMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Services, P.C. CurrentSince Aug 2, 2004 Accepting new patients
Wih Faculty Physicians, Inc PastSince Jan 1, 2020 Accepting new patients

Locations

17 Case St
Norwich, CT 06360
Phone (860) 886-2461

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1376638858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CASE STREET",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-886-2461",
            "fax_number": "860-887-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CASE STREET",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-886-2461",
            "fax_number": "860-887-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGFELD",
        "first_name": "MELISSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "003126",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CT",
            "license": "003126",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004249307",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.