Active NPI
Erik Bergeson, PA
- Medical Physician Assistant
- Spokane, WA
National Provider Identifier
1437196870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA60120173
- Practice address
- 400 E 5TH Ave
Spokane, WA 99202-1334 - Phone
- (509) 838-2531
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 004184 | GA | |
| Medical Physician Assistant | 363AM0700X | PA60120173 | WA | Primary |
Addresses
Primary practice location
400 E 5TH Ave
Spokane, WA 99202-1334
Mailing address
400 E 5TH Ave
Spokane, WA 99202-1334
Phone (509) 838-2531
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00426902 | Other | GA | RAILROAD MEDICARE |
| 009933554 | Medicaid | AL | |
| 865184205A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA60120173 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sterling Emergency Services of the Southeast Inc | Medical | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Eatonton, GA
- NPI 1992763627
Medical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263168000000",
"number": "1437196870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 5TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021334",
"telephone_number": "509-838-2531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 5TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021334",
"telephone_number": "509-838-2531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGESON",
"first_name": "ERIK",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2010-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "004184",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA60120173",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00426902",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009933554",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "865184205A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.