| Dr Carmen Renee Bergom, MD | |
|
1255 Graham Rd, Dept Radiation Oncology, Florissant, MO 63031-8014 | |
| (314) 820-6751 | |
| (314) 820-6752 |
| Full Name | Dr Carmen Renee Bergom |
|---|---|
| Gender | Female |
| Speciality | Radiation Oncology |
| Experience | 17 Years |
| Location | 1255 Graham Rd, Florissant, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932363553 | NPI | - | NPPES |
| 200089105 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 2020031317 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christian Hospital Northeast | Saint louis, MO | Hospital |
| Barnes Jewish Hospital | Saint louis, MO | Hospital |
| Barnes-jewish West County Hospital | Creve coeur, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Washington University | 9830008770 | 2782 |
| Washington University Physicians In Illinois, Inc | 4789945163 | 117 |
| Entity Name | Washington University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316987886 PECOS PAC ID: 9830008770 Enrollment ID: O20040927000068 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Carmen Renee Bergom, MD Po Box 7412011, Chicago, IL 60674-2011 Ph: (314) 820-6751 | Dr Carmen Renee Bergom, MD 1255 Graham Rd, Dept Radiation Oncology, Florissant, MO 63031-8014 Ph: (314) 820-6751 |
Daniel L. Sexton Jr., M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 235 Dunn Rd, Florissant, MO 63031 Phone: 314-837-2882 Fax: 314-837-6465 | |
Richard A Koch, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 125 Dunn Rd, Florissant, MO 63031 Phone: 314-921-9555 Fax: 314-921-5525 | |
Dr. Kimberly H Foust, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 125 Dunn Rd, Metro Imaging, Florissant, MO 63031 Phone: 314-921-9555 Fax: 314-921-5525 | |
Dr. Jay Welch Albovias, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 201 Dunn Rd, Florissant, MO 63031 Phone: 314-830-3841 Fax: 314-831-0153 |