Individual provider Active NPI

Maricela Bergstrom, MSN APRN FNP-BC

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1992218762
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135838 Issued in TX
Practice address
823 Congress Ave Ste 150-518
Austin, TX 78701-2405
Phone
(888) 380-0988
Fax
(289) 236-3022
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135838 TX Primary

Addresses

Primary practice location

823 Congress Ave Ste 150-518
Austin, TX 78701-2405

Mailing address

2950 Buskirk Ave Ste 300
Walnut Creek, CA 94597-6900
Phone (888) 380-0988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200415002805 TX Practitioner - Nurse Practitioner 3971933920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance Medical FoundationGroup PAC ID 1153409867, 178 clinicians

Practice addresses (Care Compare)

4770 N Expressway
Brownsville, TX 78526-3108

4770 N Expressway
Suite 101
Brownsville, TX 78526-3106
Phone (956) 362-3980

510 Victoria LN
Suite 5
Harlingen, TX 78550-3231
Phone (956) 428-4221

5501 S McColl Rd
Edinburg, TX 78539-5503
Phone (956) 362-2171

910 E 8TH St
Suite 2
Weslaco, TX 78596-4346
Phone (956) 362-7020

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP135838TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Medical Foundation Family CurrentSince Oct 1, 2024 Accepting new patients
Valley Ear Nose & Throat Specialist PA PastSince Jan 1, 1999 Accepting new patients

Locations

4770 N Expressway
Ste 304
Brownsville, TX 78526
Phone (956) 350-8787

4770 N Expressway
Ste 301
Brownsville, TX 78526
Phone (956) 362-3715

2821 W Michaelangelo Dr
Ste 102B
Edinburg, TX 78539
Phone (956) 362-7020

2821 W Michaelangelo Dr
Ste 301
Edinburg, TX 78539
Phone (956) 362-2429

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

510 Victoria Ln
Ste 5
Harlingen, TX 78550
Phone (956) 428-4221

2101 S Cynthia St
Ste A
McAllen, TX 78503
Phone (956) 362-7020

910 E 8th St
Ste 2
Weslaco, TX 78596
Phone (956) 362-7020

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 2

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": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1992218762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 BUSKIRK AVE STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945976900",
            "telephone_number": "888-380-0988",
            "fax_number": "289-236-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 CONGRESS AVE STE 150-518",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012405",
            "telephone_number": "888-380-0988",
            "fax_number": "289-236-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "MARICELA",
        "name_prefix": "Mrs.",
        "credential": "MSN APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.