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DR. CHARLES A BERGSTROM M.D.
NPI 1104886662
Family Medicine in Fayetteville, GA

Active since March 27, 2006PECOS Enrolled
108 NORTH PARK DR., FAYETTEVILLE, GA 30214(770) 461-3466(770) 461-3884 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Charles A Bergstrom M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHARLES A BERGSTROM M.D. (NPI 1104886662) is an individual family medicine provider in Fayetteville, Georgia, licensed in Georgia (033030) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104886662
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. CHARLES A BERGSTROMCredential: M.D.
Location Address108 NORTH PARK DR.Fayetteville, GA 30214
Mailing Address108 N Park DrFayetteville, GA 30214-1645 · (770) 461-3466 · Fax (770) 461-3884
Phone(770) 461-3466
Fax(770) 461-3884
Sole ProprietorNo
Enumeration DateMarch 27, 2006
Last NPPES UpdateDecember 30, 2021
NPPES CertifiedDecember 30, 2021
✔ NPI 1104886662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 033030
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedSpecialistTaxonomy 174400000X · License 033030 (GA)
108 NORTH PARK DR., Fayetteville, GA 30214
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Other Identifiers 2

Other1104886662GA · Npi
Other52030615GA · Bcbs Of Ga

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Charles A Bergstrom M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
228 services104 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
86 services86 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
47 services35 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30214 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
95%298 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
86%477 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%508 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%498 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers60 claims118 services$5.52 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers16 claims16 services$0.93 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
2 suppliers11 claims11 services$48.52 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Bergstrom's NPI number?

The NPI number for Charles Bergstrom is 1104886662. It was assigned to this individual provider in the NPPES registry on March 27, 2006.

Where is Charles Bergstrom located?

Charles Bergstrom practices at 108 North Park Dr., Fayetteville, GA 30214. The listed phone number is (770) 461-3466.

What is Charles Bergstrom's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Charles Bergstrom enrolled in Medicare?

Yes. Charles Bergstrom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Charles Bergstrom was last updated on December 30, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.