Andrew Michael Bergeron, PT, DPT
Individual provider Active NPI Physical Therapist · Covington, LA
NPI 1760809347 · NPPES record last updated Oct 24, 2016
Key facts
- NPI
- 1760809347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 08764R (LA)
- Practice address
- 71121 Hwy 21
Ste D
Covington, LA 70433 - Phone
- (985) 898-3979
- Fax
- (985) 898-3981
- NPI assigned
- Mar 21, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Administrators of the Tulane Educational Fund
Practice addresses (Care Compare)
7030 Canal Blvd
Suite 110
New Orleans, LA 70124-3410
Phone (504) 988-0100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140505000603 | LA | Practitioner - Physical Therapist in Private Practice | 4385877083 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Administrators of the Tulane Educational Fund | Current |
Accepting new patients | |
| Administrators of the Tulane Educational Fund | Current |
Accepting new patients |
Locations
7030 Canal Blvd
Ste 110
New Orleans, LA 70124
Phone (504) 456-5152
1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 08764R | LA | Yes |
Addresses
Primary practice location
71121 Hwy 21
Ste D
Covington, LA 70433
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217
Other providers in Covington, LA
- Kristine Benefield
- Fran Benigno
- Christa Bennett
- Chloe Benoit
- Gregory Thomas Benton
- Richard Scott Bermudez
- Jason E Bernard
- Samantha Wyatt Bernard
- Adam Berthelot
- Margaret Katherine Beyrau
All providers in Covington, LA · Physical Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.