| Lisa Marie Bergeron, APRN | |
|
627 Norwich Salem Tpke Unit 2, Oakdale, CT 06370-1066 | |
| (860) 222-0949 | |
| (888) 326-5828 |
| Full Name | Lisa Marie Bergeron |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 15 Years |
| Location | 627 Norwich Salem Tpke Unit 2, Oakdale, Connecticut |
| 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 |
|---|---|---|---|
| 1366715179 | NPI | - | NPPES |
| 004235900 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 4923 (Connecticut) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mhs Primary Care, Inc. | 4082507371 | 151 |
| Trinity Health Of New England Urgent Care Pllc | 9436561388 | 12 |
| Entity Name | Afc Physicians Of Connecticut Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003152984 PECOS PAC ID: 5193966893 Enrollment ID: O20130723000274 |
| Entity Name | Quentin Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487087250 PECOS PAC ID: 4981833647 Enrollment ID: O20140130000098 |
| Entity Name | Mhs Primary Care, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093138935 PECOS PAC ID: 4082507371 Enrollment ID: O20140814001234 |
| Entity Name | Qmg 2 Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437546363 PECOS PAC ID: 0345541512 Enrollment ID: O20151211000754 |
| Entity Name | Qmg4 Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023471299 PECOS PAC ID: 4284912957 Enrollment ID: O20161031002469 |
| Entity Name | Qmg3 Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053856039 PECOS PAC ID: 8628353117 Enrollment ID: O20170324000321 |
| Entity Name | Hartford Healthcare Urgent Care Centers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093239683 PECOS PAC ID: 7618242777 Enrollment ID: O20170929001464 |
| Entity Name | Trinity Health Of New England Urgent Care Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447867452 PECOS PAC ID: 9436561388 Enrollment ID: O20201217000260 |
| Entity Name | Qmg5 Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386233344 PECOS PAC ID: 2062820913 Enrollment ID: O20210414002118 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Marie Bergeron, APRN 627 Norwich Salem Tpke Unit 2, Oakdale, CT 06370-1066 Ph: (860) 222-0949 | Lisa Marie Bergeron, APRN 627 Norwich Salem Tpke Unit 2, Oakdale, CT 06370-1066 Ph: (860) 222-0949 |