Courtney Taylor Bergmooser

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010243 Issued in MI

Practice address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Phone

(734) 936-4000

NPI assigned

Nov 6, 2020

Sex

Female

Sole proprietor

No

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 MI

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbergmooser1117309@direct.hfhs.org

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.

• Regents of the University of Michigan

  • Physician Assistant
  • Ann Arbor, MI
  • NPI 1689609448
  Medicare reassignment Care Compare group
• Regents of the University of Michigan

  • Physician Assistant
  • Brighton, MI
  • NPI 1457378036
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1689275497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37000 Grand River Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483352868",
            "country_code": "US",
            "telephone_number": "248-536-2127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7125 Orchard Lake Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223616",
            "country_code": "US",
            "telephone_number": "248-865-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGMOOSER",
        "first_name": "COURTNEY",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Bergey
• Caroline Marie Berglund, M.D.
• Erica Berglund, MD
• John Joseph Berglund III, MD
• Carrie Lynn Bergmans, PA-C
• Frederick Michael Bergstrom, RPH
• Ramon Berguer, MD
• Mikayla Bergwood
• Aron T Berhane, PA-C
• Mini Beri

• Physician Assistant in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.