Active NPI
Katherine Bergamo, FNP
- Family Nurse Practitioner
- Middletown, NY
National Provider Identifier
1578833844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F336906
- Practice address
- 111 Maltese Dr
Middletown, NY 10940-2115 - Phone
- (845) 342-4774
- Fax
- (845) 343-8741
- NPI assigned
- Jan 4, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F336906 | NY | Primary |
Addresses
Primary practice location
111 Maltese Dr
Middletown, NY 10940-2115
Mailing address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F336906 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F336906 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Horizon Medical Group, P.C. | Past | Accepting new patients | |
| Horizon Medical Group, P.C. | Past | Accepting new patients |
Locations
178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456
1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DGICBA
- kbergamo347806@bassett.direct-ci.net
- ms_kbergamo@landmarkhealth-direct.org
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Cooperstown, NY
- NPI 1083664221
-
- Specialty Pharmacy
- Oneonta, NY
- NPI 1174419196
-
- Family Medicine Physician
- Goshen, NY
- NPI 1063488179
-
- Durable Medical Equipment & Medical Supplies
- Yorktown Heights, NY
- NPI 1386520021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614643200000",
"number": "1578833844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ATWELL RD",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133261301",
"telephone_number": "607-547-3273",
"fax_number": "607-547-4648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MALTESE DR",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402115",
"telephone_number": "845-342-4774",
"fax_number": "845-343-8741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGAMO",
"first_name": "KATHERINE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-04",
"last_updated": "2021-03-02",
"certification_date": "2021-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F336906",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "F336906",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.