Jessica Leigh Bergstrom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA058785 Issued in PA

Practice address

605 W State St
Media, PA 19063-2620

Phone

(610) 565-8600

Fax

(610) 891-9238

NPI assigned

Jan 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment
• Macisaac Family Medicine

  • Family Medicine Physician
  • Warrendale, PA
  • NPI 1881615003
  Medicare reassignment
• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment
• University of Penn - Medical Group

  • Hospitalist Physician
  • Philadelphia, PA
  • NPI 1053447151
  Medicare reassignment
• Upmc Community Medicine, Inc

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1558976092
  Medicare reassignment
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107
  NPD
• St Luke'S Physician Group Inc

  • Colon & Rectal Surgery Physician
  • Bethlehem, PA
  • NPI 1306563838
  NPD
• St Luke'S Physician Group Inc

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• University of Penn - Medical Group

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1114481504
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• Upmc Community Medcine Inc

  • Family Medicine Physician
  • Hermitage, PA
  • NPI 1023806676
  NPD
• Upmc Community Medicine Inc

  • Internal Medicine Physician
  • Monroeville, PA
  • NPI 1558098830
  NPD

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1497290282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W STATE ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "610-565-8600",
            "fax_number": "610-891-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W STATE ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "610-565-8600",
            "fax_number": "610-891-9238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151000",
            "country_code": "US",
            "telephone_number": "484-526-6643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martine Benoit
• Joseph Bentivoglio, ATC
• Diana L Bergbauer, PT
• Denise Berger
• Mitchell B Berger, M.D.
• Kimberly Lynn Bernardi, LCSW
• Jonathan Berridge, LAT ATC OTC
• Aaron S Best, DO
• Marcela Andrea Betancourt, MD
• Betty Lou - Bettner, PH.D. LPC

• Physician Assistant in Media, PA
• Providers in Media, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.