Active NPI
Jordan Bergmann, M.D.
- General Practice Physician
- San Diego, CA
National Provider Identifier
1548796196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 37335
- Practice address
- Naval Medical Ctr
34800 Bob Wilson Dr
San Diego, CA 92134-0001 - Phone
- (619) 532-6827
- Fax
- (619) 532-7508
- NPI assigned
- May 2, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | |||
| General Practice Physician | 208D00000X | 37335 | AL | Primary |
Addresses
Primary practice location
Naval Medical Ctr
34800 Bob Wilson Dr
San Diego, CA 92134-0001
Mailing address
4494 Palmer Rd N
Bethesda, MD 20814-0001
Phone (301) 295-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Tulane University School of Medicine, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1001 N Coast Hwy
Apt 375
Oceanside, CA 92054-2316
PO Box
Suite 34120
Reno, NV 89533
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37335 | AL | MD | General Practice Physician |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- San Diego, CA
- NPI 1942024393
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1548796196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4494 PALMER RD N",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208140001",
"telephone_number": "301-295-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL MEDICAL CTR",
"address_2": "34800 BOB WILSON DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921340001",
"telephone_number": "619-532-6827",
"fax_number": "619-532-7508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMANN",
"first_name": "JORDAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-02",
"last_updated": "2023-08-23",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "AL",
"license": "37335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.