NPIMap

Organization Active NPI

Bergman Cosmetic Surgery, PC

  • Plastic Surgery Physician
  • Des Moines, IA
National Provider Identifier
1689629503
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
BERGMAN COSMETIC SURGERY, PC
Practice address
2000 Grand Ave
Des Moines, IA 50312-4920
Phone
(515) 222-1111
Fax
(515) 244-9914
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Dr. Ronald S Bergman, DO
Title
President Ceo
Phone
(515) 222-1111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208200000X IA Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X IA

Addresses

Primary practice location

2000 Grand Ave
Des Moines, IA 50312-4920

Mailing address

PO Box 71602
Clive, IA 50325-0602
Phone (515) 243-2057

Other identifiers 1

IdentifierTypeStateIssuer
0422980MedicaidIA

Other names 1

  • Dr. Ronald S Bergman DO PC Former legal business name

National Provider Directory

National Provider Directory

Locations

532 1st St NW
#A
Britt, IA 50423
Phone (641) 843-5000

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1689629503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71602",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503250602",
            "telephone_number": "515-243-2057",
            "fax_number": "515-244-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124920",
            "telephone_number": "515-222-1111",
            "fax_number": "515-244-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGMAN COSMETIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "515-222-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0422980",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Ronald S Bergman DO PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Dr. Ronald S Bergman DO PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.