Kenneth S Bergman, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

MD00030100 Issued in WA

Practice address

11511 Canterwood Blvd NW
Suite 50
Gig Harbor, WA 98332-5813

Phone

(253) 851-5155

Fax

(253) 851-5367

NPI assigned

Feb 1, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Radiation Oncology

Education

University of California, Geffen School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Cancer Care PLLCGroup PAC ID 9739443391, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sound Cancer Care PLLC

  • Radiation Oncology Physician
  • Puyallup, WA
  • NPI 1487168324
  Medicare reassignment Care Compare group NPD
• Northwest Medical Specialties Pharmacy

  • Clinic Pharmacy
  • Tacoma, WA
  • NPI 1053489062
  NPD (past)
• Peninsula Rad Onc Ctr LLC

  • Radiology Clinic/Center
  • Gig Harbor, WA
  • NPI 1366694796

  Radiation Oncology

  NPD (past)
• Universal Treatment Center, Inc

  dba Auburn Regional Center for Cancer Care

  • Radiation Oncology Clinic/Center
  • Auburn, WA
  • NPI 1932325313
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1669443032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 MLK JR WAY",
            "address_2": "STE 11",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-627-6172",
            "fax_number": "253-627-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD NW",
            "address_2": "SUITE 50",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-851-5155",
            "fax_number": "253-851-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "KENNETH",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD00030100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8293987",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nick Foster Bennett, D.O.
• Jamie Marie Benoit
• Bianca Benson, RN
• Richard Benson, LICSW, SUDP, MAC
• Patricia Benton, D.M.D.
• Molly Bernardi, LCMHW
• Isabella Jade Bernazzani, LMT
• Gordon Bernstein, M.D.
• Trisha Bertholf, LMP
• Ashleigh Bertolini, DC

• Radiation Oncology Physician in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Radiation Oncology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.

Verify at the official NPI Registry.