Bergomy Jeannis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

224229 Issued in MA

Practice address

15 Pearson Ave Apt 2
Somerville, MA 02144-2305

Phone

(617) 501-1969

NPI assigned

May 29, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Massachusetts Luna Care Physical Therapy LLCGroup PAC ID 8628468998, 26 clinicians

Advance Physical Therapy and Sport RehabGroup PAC ID 2668535089, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advance Physical Therapy & Sport Rehab

  • Point of Service
  • Lynn, MA
  • NPI 1417163817

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Massachusetts Luna Care Physical Therapy LLC

  • Physical Therapist
  • Boston, MA
  • NPI 1427713742
  Medicare reassignment Care Compare group NPD
• Fox Rehab Ma LLC

  • Physical Therapist
  • Waltham, MA
  • NPI 1497174437
  Medicare reassignment NPD

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1659939288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PEARSON AVE APT 2",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442305",
            "telephone_number": "617-501-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PEARSON AVE APT 2",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442305",
            "telephone_number": "617-501-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANNIS",
        "first_name": "BERGOMY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "224229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Jay
• Samuelle A Jean Charles
• Andrele Jean-Charles, AAMFT
• Myrlene Jean-Venant
• Daphney Jean, LPN
• Sophie Madeleine Jennett, LICSW
• Je Hee Jeon, PHARMD
• Wilson Jesus
• Noel M. Jette, L.I.C.S.W.
• Stephanie Jeudy

• Physical Therapist in Somerville, MA
• Providers in Somerville, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.