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DR. JACK M. BERGSTEIN M.D.
NPI 1154366300
Surgery in Marysville, WA

Active since June 19, 2006PECOS EnrolledAccepts Medicare Assignment
7205 54TH PL NE UNIT A, MARYSVILLE, WA 98270(724) 833-2171(360) 386-8019 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 17, 2018, Jan 10, 2018 (2 updates tracked since 2018).

About Dr. Jack M. Bergstein M.d. NPPES

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

DR. JACK M. BERGSTEIN M.D. (NPI 1154366300) is an individual surgery provider in Marysville, Washington, licensed in Washington (MD60641501) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Clarksville, and is a graduate of University Of Minnesota Medical School (1982).

NPPES Registry Identity

NPI1154366300
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. JACK M. BERGSTEINCredential: M.D.
Location Address7205 54TH PL NE UNIT AMarysville, WA 98270-8932
Mailing Address7205 54th Pl Ne Unit AMarysville, WA 98270-8932 · (724) 833-2171 · Fax (360) 386-8019
Phone(724) 833-2171
Fax(360) 386-8019
Sole ProprietorYes
Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1982
Enumeration DateJune 19, 2006
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1154366300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in WA · MD60641501
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedSpecialistTaxonomy 174400000X · License MD422547 (PA)
7205 54TH PL NE UNIT A, Marysville, WA 98270
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Secondary Practice Location 1

Location 1221 Pitgas RdClarksville, PA 15322-7367 · Phone (724) 833-2171 · Fax (724) 377-0571

Other Identifiers 5

Medicaid0012111170005PA
Other00026626302PA · Univera Healthcare
Other147447PA · Unison
Other1548575PA · Blue Cross Blue Shield
Other305022PA · Upmc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack M. Bergstein M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254224199
PECOS Enrollment IDI20251125001368
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jack Bergstein reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Robert Marriott Medical Corp
994 mi
Surgery
222 N PACIFIC COAST HWY STE 2175
El Segundo, CA 90245
  • Reassigned Medicare billing, Washington enrollment
  • 5 clinicians in this Medicare group
NPI 1083883938 (877) 878-3289
Signify Health Medical Associates, PLLC
1,679 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Pennsylvania and Washington enrollments
  • 553 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98270 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Jack Bergstein's NPI number?

The NPI number for Jack Bergstein is 1154366300. It was assigned to this individual provider in the NPPES registry on June 19, 2006.

Where is Jack Bergstein located?

Jack Bergstein practices at 7205 54th Pl NE Unit A, Marysville, WA 98270. The listed phone number is (724) 833-2171.

What is Jack Bergstein's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Jack Bergstein enrolled in Medicare?

Yes. Jack Bergstein is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jack Bergstein's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Bergstein reassigns Medicare benefits to 2 organizations: Robert Marriott Medical Corp (El Segundo, CA) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Bergstein's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jack Bergstein accept?

Health plans from CareSource and CareSource (Common Ground Healthcare) list Jack Bergstein as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Bergstein was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.