Individual provider Active NPI

Marie-Christine Bergeron, DPM

  • Foot & Ankle Surgery Podiatrist
  • Marietta, GA
National Provider Identifier
1447653761
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD001262 Issued in GA
Practice address
3225 Shallowford Rd Ste 200
Marietta, GA 30062-1288
Phone
(770) 675-7904
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD001262 GA Primary

Addresses

Primary practice location

3225 Shallowford Rd Ste 200
Marietta, GA 30062-1288

Mailing address

3225 Shallowford Rd Ste 200
Marietta, GA 30062-1288
Phone (770) 675-7904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160503001399 GA Practitioner - Podiatry 6103125778 Reassigns benefits to 1 organization
I20180427001272 NY Practitioner - Podiatry 6103125778 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue11
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group CurrentSince Jan 11, 2023 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince May 31, 2018 Accepting new patients
Foot Clinics of New York CurrentSince Apr 1, 2018 Accepting new patients
Harlem Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients
Metropolitan Medical Practice Plan PC CurrentSince May 14, 2018 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2701 N Decatur Rd
Rm 2758
Decatur, GA 30033

2470 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

55 E 124th St
New York, NY 10035
Phone (212) 410-8112

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

45 Research Way
Ste 206
Setauket, NY 11733
Phone (631) 575-9300

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1447653761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621288",
            "telephone_number": "770-675-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621288",
            "telephone_number": "770-675-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "MARIE-CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.