Sean Bergen
Individual provider Active NPI Paramedic · Albuquerque, NM
NPI 1538752191 · NPPES record last updated Feb 15, 2021
Key facts
- NPI
- 1538752191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Paramedic 146L00000X
- License
- 19988 (NM)
- Practice address
- 4808 Valle Santo TRL NW
Albuquerque, NM 87120-4684 - Phone
- (505) 440-6684
- NPI assigned
- Feb 15, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19988 | NM | MD | Paramedic |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Mexico Community Care | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | 19988 | NM | Yes |
Addresses
Primary practice location
4808 Valle Santo TRL NW
Albuquerque, NM 87120-4684
Mailing address
4808 Valle Santo TRL NW
Albuquerque, NM 87120-4684
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.