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Individual provider Active NPI

Emily Victoria Berganini, PA-C

  • Medical Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1780093641
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0004891 Issued in CO
Practice address
2121 E Harmony Rd
Unit 170
Fort Collins, CO 80528-3413
Phone
(970) 493-6337
Fax
(970) 493-3528
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017831 NY
Medical Physician Assistant 363AM0700X PA.0004891 CO Primary

Addresses

Primary practice location

2121 E Harmony Rd
Unit 170
Fort Collins, CO 80528-3413

Mailing address

2121 E Harmony Rd
Unit 170
Fort Collins, CO 80528-3413
Phone (970) 493-6337

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131001405 CO Practitioner - Physician Assistant 7214237510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

131 Stanley Ave
Suite 202
Estes Park, CO 80517-6356
Phone (970) 586-2343

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2121 E Harmony Rd
Fort Collins, CO 80528-3401

2121 E Harmony Rd
Fort Collins, CO 80528-3413

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017831NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Feb 27, 2017 Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2121 E Harmony Rd
Unit 170
Fort Collins, CO 80528
Phone (970) 493-6337

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 1
Greeley, CO 80634
Phone (970) 652-2477

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

2500 Rocky Mountain Ave
Ste 2100
Loveland, CO 80538
Phone (970) 203-7153

Organizations & group practices 2

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1780093641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "address_2": "UNIT 170",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283413",
            "telephone_number": "970-493-6337",
            "fax_number": "970-493-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "address_2": "UNIT 170",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283413",
            "telephone_number": "970-493-6337",
            "fax_number": "970-493-3528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGANINI",
        "first_name": "EMILY",
        "middle_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017831",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0004891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.