Patrick R. Bergevin, MD
Individual provider Active NPI Hematology & Oncology Physician · Sayre, PA
NPI 1831162361 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831162361
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- License
- MD043681-L (PA)
- Practice address
- 1 Guthrie SQ
Sayre, PA 18840-1625 - Phone
- (570) 888-5858
- Fax
- (570) 882-3007
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121069-1 | NY | MD | Hematology & Oncology Physician |
| MD043681-L | PA | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teribury Medical Associates PC | Past |
Accepting new patients | |
| Guthrie Medical Group, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | MD043681-L | PA | Yes |
| Hematology & Oncology Physician | 207RH0003X | 121069-1 | NY |
Addresses
Primary practice location
1 Guthrie SQ
Sayre, PA 18840-1625
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016665380001 | Medicaid | PA | |
| 00640560 | Medicaid | NY |
Other providers in Sayre, PA
- Murali Ranjani Behara
- Francis Gabriel Belardi
- Paula S Bennett
- Michael John Benyo
- Michael D. Beredo
- Michelle Bernshteyn
- Christopher Leonard Berry
- Mackensie Elisabeth Berry
- Bert'S Pharmacy, Inc.
- David J. Bertsch
All providers in Sayre, PA · Hematology & Oncology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.