Individual provider Active NPI

Recha Bergstrom, MD

  • Diagnostic Radiology Physician
  • Palo Alto, CA
National Provider Identifier
1821000456
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A79519 Issued in CA
Practice address
795 El Camino Real
Palo Alto, CA 94301-2302
Phone
(650) 853-2955
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A79519 CA Primary

Addresses

Primary practice location

795 El Camino Real
Palo Alto, CA 94301-2302

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 853-2955

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031230000370 CA Practitioner - Diagnostic Radiology 6709784697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79519CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Jan 26, 2004 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jan 26, 2004 Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
#C40876
Los Altos, CA 94022
Phone (415) 254-5200

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

2950 Whipple Ave
Redwood City, CA 94062
Phone (650) 364-2864

290 Redwood Shores Pkwy
Redwood City, CA 94065
Phone (650) 598-3160

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: rbergstrommd60598@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1821000456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "650-853-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 EL CAMINO REAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012302",
            "telephone_number": "650-853-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "RECHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A79519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.