Carmen Renee Bergom, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

2020031317 Issued in MO

Practice address

1255 Graham Rd
Dept Radiation Oncology
Florissant, MO 63031-8014

Phone

(314) 820-6751

Fax

(314) 820-6752

NPI assigned

Jul 13, 2008

Last updated

Apr 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI, MO, IL3 enrollments

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 3

Specialty

Radiation Oncology

Education

Medical College of Wisconsin, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington University Physicians in Illinois IncGroup PAC ID 4789945163, 168 clinicians

Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

Merit-based Incentive Payment System (MIPS)

Final score

84.2 of 100Reported as group

Quality

71.6

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbergom1286835@direct.carenet.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1316987886
  Medicare reassignment Care Compare group NPD
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • O'Fallon, IL
  • NPI 1477076263
  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1457203135
  NPD
• Washington University Physicians in Illinois, Inc

  dba WUPI - Department of Otolaryngology

  • Multi-Specialty Clinic/Center
  • Swansea, IL
  • NPI 1871132449
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1134169568
  NPD (past)

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

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation
• Barnes Jewish West County Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1831107895
  Care Compare affiliation
• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  dba Christian Hospital

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation

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

{
    "created_epoch": "1215907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1932363553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-820-6751",
            "fax_number": "314-820-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 GRAHAM RD",
            "address_2": "DEPT RADIATION ONCOLOGY",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318014",
            "telephone_number": "314-820-6751",
            "fax_number": "314-820-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGOM",
        "first_name": "CARMEN",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-13",
        "last_updated": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2020031317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200089105",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1255 Graham Rd",
            "address_2": "Dept Radiation Oncology",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Felicia R Bentley, MD
• Bentwood Healthcare LLC (Bent-Wood Nursing Center)
• Alexander Berezin, M.S.W.
• Gabrielle Berolatti
• Lawayna Berry
• Sharon Denise Berry, LCSW
• Best Home Care LLC
• Betty Jean Kerr People's Health Center

• Radiation Oncology Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Radiation Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.