Jodi Ann Bergstrom, OD is a medicare enrolled "Optometrist" provider in Centuria, Wisconsin. She went to Illinois College Of Optometry At Chicago and graduated in 2016 and has 10 years of diverse experience with area of expertise as Optometry. She is a member of the group practice Visionworks Inc, Visionworks Inc, Visionworks Inc, Visionworks Inc, Visionworks Inc, The Lakes Community Health Center Inc and her current practice location is
416 Superior Avenue, Centuria, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 646-1336.
Jodi Ann Bergstrom is licensed to practice in Wisconsin (license number 2281) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1568511095.
Healthcare Provider's Profile
| Full Name | Jodi Ann Bergstrom |
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| Gender | Female |
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| Speciality | Optometry |
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| Experience | 10 Years |
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| Location | 416 Superior Avenue, Centuria, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jodi Ann Bergstrom attended and graduated from Illinois College Of Optometry At Chicago in 2016
NPI Data:
- NPI Number: 1568511095
- Provider Enumeration Date: 01/10/2007
- Last Update Date: 12/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 3779680483
- Enrollment ID: I20241219000735
Medical Identifiers
Medical identifiers for Jodi Ann Bergstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568511095 | NPI | - | NPPES |
| 38594500 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 3054 (Maryland) | Secondary |
| 152W00000X | Optometrist | 2281 (Wisconsin) | Primary |
| 152W00000X | Optometrist | 2231 (Minnesota) | Secondary |
| 152W00000X | Optometrist | 1643 (Nebraska) | Secondary |
| 152W00000X | Optometrist | 4901005835 (Michigan) | Secondary |
| 152W00000X | Optometrist | TPOP218 (Florida) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Visionworks Inc | 4385639616 | 12 |
| Visionworks Inc | 4385639616 | 12 |
| Visionworks Inc | 4385639616 | 12 |
| Visionworks Inc | 4385639616 | 12 |
| Visionworks Inc | 4385639616 | 12 |
| The Lakes Community Health Center Inc | 0840366654 | 109 |
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. Jodi Ann Bergstrom allows following entities to bill medicare on her behalf.
| Provider Name | Visionworks Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1104847912
PECOS PAC ID: 4385639616
Enrollment ID: O20040423000298 |
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| Provider Name | Lexington Park Optometry Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1477673879
PECOS PAC ID: 0749404416
Enrollment ID: O20140619001327 |
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| Provider Name | Myeyedr Optometry Of Maryland Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1609204437
PECOS PAC ID: 6002037629
Enrollment ID: O20141024000821 |
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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. Jodi Ann Bergstrom 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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Jodi Ann Bergstrom, OD
416 Superior Avenue, Po Box 400,
Centuria, WI 54824
Ph: (715) 646-1336 | Jodi Ann Bergstrom, OD
416 Superior Avenue,
Centuria, WI 54824
Ph: (715) 646-1336 |
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