NPIMap

Individual provider Active NPI

Jeffrey M Bergeson, D.O.

  • Orthopaedic Surgery Physician
  • Auburn, CA
National Provider Identifier
1467575654
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
20A9815 Issued in CA
Practice address
11795 Education St
Suite 110
Auburn, CA 95602-2454
Phone
(530) 886-6820
Fax
(530) 886-6821
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 20A9815 CA Primary

Addresses

Primary practice location

11795 Education St
Suite 110
Auburn, CA 95602-2454

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
00AX98150MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070725000597 CA Practitioner - Orthopedic Surgery 5496856122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

  • Sutter Auburn Faith Vna & Hospice Home health agency, Auburn, CA, CCN 557292
  • Sutter Care at Home Home health agency, Roseville, CA, CCN 057545
  • Progressive Home Care - Auburn Home health agency, Auburn, CA, CCN 557482
  • Sutter Care at Home Home health agency, Yuba City, CA, CCN 557785
  • Marshall Home Care Home health agency, Diamond Springs, CA, CCN 057019
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement131
Knee replacement105
Lower limb (leg) arthroscopy (minimally invasive joint repair)24
Upper limb (arm) arthroscopy (minimally invasive joint repair)45
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9815CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Orthopaedic Surgery Current Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: jbergesondo19536@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1467575654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11795 EDUCATION ST",
            "address_2": "SUITE 110",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956022454",
            "telephone_number": "530-886-6820",
            "fax_number": "530-886-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGESON",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "20A9815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX98150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.