Douglas Alan Bergstrom, PHD - Medicare Psychologist in Prescott, AZ

Douglas Alan Bergstrom, PHD is a medicare enrolled "Psychologist - Clinical" provider in Prescott, Arizona. He graduated from medical school in 1983 and has 41 years of diverse experience with area of expertise as Clinical Psychologist. His current practice location is 143 E Merritt St, Prescott, Arizona. You can reach out to his office (for appointments etc.) via phone at (928) 445-3835.

Douglas Alan Bergstrom is licensed to practice in Arizona (license number 1142) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063536688.

Contact Information

Douglas Alan Bergstrom, PHD
143 E Merritt St,
Prescott, AZ 86301-2028
(928) 445-3835
(928) 445-7071

Map and Direction




Healthcare Provider's Profile

Full NameDouglas Alan Bergstrom
GenderMale
SpecialityClinical Psychologist
Experience41 Years
Location143 E Merritt St, Prescott, Arizona
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Douglas Alan Bergstrom graduated from medical school in 1983
  NPI Data:
  • NPI Number: 1063536688
  • Provider Enumeration Date: 03/19/2007
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 9931134327
  • Enrollment ID: I20051005000081

Medical Identifiers

Medical identifiers for Douglas Alan Bergstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063536688NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 1142 (Arizona)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. Douglas Alan Bergstrom allows following entities to bill medicare on his behalf.
Entity NameDouglas A. Bergstrom, Ph.d., Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154501682
PECOS PAC ID: 2860581816
Enrollment ID: O20071129000057

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. Douglas Alan 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 AddressPractice Location Address
Douglas Alan Bergstrom, PHD
143 E Merritt St,
Prescott, AZ 86301-2028

Ph: (928) 445-3835
Douglas Alan Bergstrom, PHD
143 E Merritt St,
Prescott, AZ 86301-2028

Ph: (928) 445-3835

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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