Individual provider Active NPI

Megan Bergeron

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1619576717
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
309937 Issued in NY
Practice address
222 E 41St St
New York, NY 10017-6739
Phone
(646) 825-6300
NPI assigned
Oct 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 713936 NY
Nurse Practitioner 363L00000X 309937 NY Primary

Addresses

Primary practice location

222 E 41St St
New York, NY 10017-6739

Mailing address

289 Empire Blvd Apt 5a
Brooklyn, NY 11225-3548
Phone (609) 937-9014

Other practice location 1

289 Empire Blvd Apt 5A
Brooklyn, NY 11225-3548
Phone (609) 937-9014

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbergeron95747@nyumc.direct-ci.com

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211119000266 NY Practitioner - Nurse Practitioner 3779972393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
713936NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 1, 2022 Accepting new patients
New York University CurrentSince Jan 1, 2022 Accepting new patients

Locations

222 E 41st St
New York, NY 10017
Phone (212) 263-2573

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1619576717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 EMPIRE BLVD APT 5A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253548",
            "telephone_number": "609-937-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E 41ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176739",
            "telephone_number": "646-825-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 Empire Blvd Apt 5A",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112253548",
            "country_code": "US",
            "telephone_number": "609-937-9014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "MEGAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "713936",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "309937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbergeron95747@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "222 E 41st St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100176739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.