Individual provider Active NPI

Dean Henry Bergersen, M.D.

  • Family Medicine Physician
  • Arlington, MN
National Provider Identifier
1699737122
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19539 Issued in MN
Practice address
601 W Chandler St
Arlington, MN 55307-2127
Phone
(507) 964-2271
Fax
(507) 964-8490
NPI assigned
Apr 3, 2006
Last updated
Mar 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19539 MN Primary

Addresses

Primary practice location

601 W Chandler St
Arlington, MN 55307-2127

Mailing address

410 E Clinton St
Arlington, MN 55307-2128
Phone (507) 964-5570

Other identifiers 1

IdentifierTypeStateIssuer
583575500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sibley Medical Center PastSince Apr 30, 2003 Accepting new patients
Ridgeview Clinics Past Accepting new patients
Allina Health System Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1699737122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E CLINTON ST",
            "city": "ARLINGTON",
            "state": "MN",
            "postal_code": "553072128",
            "telephone_number": "507-964-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W CHANDLER ST",
            "city": "ARLINGTON",
            "state": "MN",
            "postal_code": "553072127",
            "telephone_number": "507-964-2271",
            "fax_number": "507-964-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERSEN",
        "first_name": "DEAN",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "19539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "583575500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.