Individual provider Active NPI

Eliza A Bergstrom, CAA

  • Anesthesiologist Assistant
  • Madison, WI
National Provider Identifier
1801156385
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
23 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-0001
Phone
(608) 263-8100
Fax
(608) 263-0575
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 23 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-0001

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Other identifiers 1

IdentifierTypeStateIssuer
100023498MedicaidWI

Other names 1

  • Eliza A Benson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120719000183 WI Practitioner - Anesthesiology Assistant 1759547771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians
Orthopaedic Associates of Wisconsin SCGroup PAC ID 1052200953, 106 clinicians

Practice addresses (Care Compare)

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Hospital & facility affiliations

  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23WIMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Wisconsin, SC CurrentSince Oct 28, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 1, 2012 Accepting new patients
Orthopaedic Associates of Wisconsin SC CurrentSince Oct 28, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 1, 2012 Accepting new patients

Locations

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

N15W28300 Golf Rd
Pewaukee, WI 53072

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1801156385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-8100",
            "fax_number": "608-263-0575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N15W28300 Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Pewaukee",
            "state": "WI",
            "postal_code": "530724800",
            "country_code": "US",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "ELIZA",
        "middle_name": "A",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100023498",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZA",
            "last_name": "BENSON",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.