Dr Kenneth Robert Bergman, MD is a medicare enrolled "Allergy & Immunology - Allergy" physician in Centreville, Virginia. His current practice location is
13890 Braddock Rd, Ste 206, Centreville, Virginia. You can reach out to his office (for appointments etc.) via phone at
(703) 263-2333.
Dr Kenneth Robert Bergman is licensed to practice in Virginia (license number 0101025702) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013912252.
Physician's Profile
| Full Name | Dr Kenneth Robert Bergman |
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| Gender | Male |
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| Speciality | Allergy & Immunology - Allergy |
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| Location | 13890 Braddock Rd, Centreville, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1013912252
- Provider Enumeration Date: 06/15/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 7517111354
- Enrollment ID: I20130204000189
Medical Identifiers
Medical identifiers for Dr Kenneth Robert Bergman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1013912252 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207KA0200X | Allergy & Immunology - Allergy | 0101025702 (Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kenneth Robert Bergman allows following entities to bill medicare on his behalf.
| Entity Name | Loudoun Medical Group, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407908817
PECOS PAC ID: 0042119661
Enrollment ID: O20040102000616 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth Robert Bergman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Kenneth Robert Bergman, MD
13890 Braddock Rd, Ste 206,
Centreville, VA 20121-2437
Ph: (703) 263-2333 | Dr Kenneth Robert Bergman, MD
13890 Braddock Rd, Ste 206,
Centreville, VA 20121-2437
Ph: (703) 263-2333 |
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