Roger L. Bergeron, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT598 Issued in ME

Practice address

585 Main St
Lewiston, ME 04240-5945

Phone

(207) 784-0153

Fax

(207) 786-6725

NPI assigned

Dec 15, 2006

Last updated

Mar 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Roger L. Bergeron, O.D.P.a.

  • Eyewear Supplier
  • Lewiston, ME
  • NPI 1629249842
  Authorized official Same address or phone

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205539200000",
    "number": "1467514356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405945",
            "telephone_number": "207-784-0153",
            "fax_number": "207-786-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405945",
            "telephone_number": "207-784-0153",
            "fax_number": "207-786-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "ROGER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114880099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD  MEDICARE-UHC",
            "identifier": "410002654",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John J Bennett, M.D.
• Justin B Bennett, MD
• Kate Benson, PT, DPT
• Charles Kevin Bergeron Poulin
• Claire E. Bergeron, MS, LADC, CCS
• Julia Frances Bergquist, LMSW-CC
• Robert W Berks, PMHNP
• Michael Scott Berlowitz, M.D.
• Kaitlyn Bernard, PHARMD
• Cristiana M Bertocchi, MD

• Optometrist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.