NPIMap

Individual provider Active NPI

Gunnar Eo Bergqvist, M.D.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Erie, PA
National Provider Identifier
1649216524
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
MD418581 Issued in PA
Practice address
410 Cranberry St
Suite 310
Erie, PA 16507-1067
Phone
(814) 480-8220
Fax
(814) 480-8225
NPI assigned
Jun 21, 2006
Last updated
May 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X MD418581 PA Primary

Addresses

Primary practice location

410 Cranberry St
Suite 310
Erie, PA 16507-1067

Mailing address

410 Cranberry St
Suite 310
Erie, PA 16507-1067
Phone (814) 480-8220

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gbergqvist@directaddress.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000312 PA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General SurgeryPractitioner - Hand Surgery 4385541499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery, Hand Surgery
Education
University of Pittsburgh School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plastic Surgery Center of PAGroup PAC ID 2567369689, 2 clinicians

Practice addresses (Care Compare)

410 Cranberry St
Suite 310
Erie, PA 16507-1069
Phone (814) 480-8009

5040 W Ridge Rd
Erie, PA 16506-1261
Phone (814) 480-8009

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy1-10
Melanoma (skin cancer) excision107
Removal of skin lesions168
Removal or shaving of skin growth578
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: gbergqvist@directaddress.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1649216524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CRANBERRY ST",
            "address_2": "SUITE 310",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071067",
            "telephone_number": "814-480-8220",
            "fax_number": "814-480-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CRANBERRY ST",
            "address_2": "SUITE 310",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071067",
            "telephone_number": "814-480-8220",
            "fax_number": "814-480-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQVIST",
        "first_name": "GUNNAR",
        "middle_name": "EO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "PA",
            "license": "MD418581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbergqvist@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "direct message",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "410 Cranberry St",
            "address_2": "Suite 310",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165071067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.