NPIMap

Individual provider Active NPI

Jennifer Lynn Bergeron, M.D.

  • Otolaryngology Physician
  • San Antonio, TX
National Provider Identifier
1447549357
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
Q0006 Issued in TX
Practice address
18518 Hardy Oak Blvd
Suite 300
San Antonio, TX 78258-4759
Phone
(210) 696-4327
NPI assigned
Mar 31, 2011
Last updated
Feb 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A111298 CA
Otolaryngology Physician 207Y00000X Q0006 TX Primary

Addresses

Primary practice location

18518 Hardy Oak Blvd
Suite 300
San Antonio, TX 78258-4759

Mailing address

18518 Hardy Oak Blvd
Suite 300
San Antonio, TX 78258-4759
Phone (210) 696-4327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141021000253 TX Practitioner - Otolaryngology 4183860968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Baylor College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Institute of Texas P aGroup PAC ID 5991800310, 12 clinicians

Practice addresses (Care Compare)

18518 Hardy Oak Blvd
Suite 300
San Antonio, TX 78258-4762
Phone (210) 363-6936

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.95 of 100Reported as individual
Quality
91.91
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Institute of Texas P a Otolaryngology CurrentSince Aug 25, 2014 Accepting new patients

Locations

18518 Hardy Oak Blvd
Ste 300
San Antonio, TX 78258
Phone (210) 696-4327

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

Hospital & facility affiliations 6

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1447549357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18518 HARDY OAK BLVD",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584759",
            "telephone_number": "210-696-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18518 HARDY OAK BLVD",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584759",
            "telephone_number": "210-696-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A111298",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "Q0006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.