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IDA M BERGSTROM M.D.
NPI 1366611352
Internal Medicine in Chevy Chase, MD

Active since February 25, 2008Opted out of Medicare · through Jun 22, 2028
5425 WISCONSIN AVE STE 810, CHEVY CHASE, MD 20815(202) 266-7070(202) 266-7073 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ida M Bergstrom M.d. NPPES

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

IDA M BERGSTROM M.D. (NPI 1366611352) is an individual internal medicine provider in Chevy Chase, Maryland, licensed in Maryland (D0071811) and active in the NPI registry since February 2008. She has opted out of Medicare through June 22, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1366611352
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameIDA M BERGSTROMCredential: M.D.
Location Address5425 WISCONSIN AVE STE 810Chevy Chase, MD 20815-3552
Mailing Address5425 Wisconsin Ave Ste 810Chevy Chase, MD 20815-3552 · (202) 266-7070 · Fax (202) 266-7073
Phone(202) 266-7070
Fax(202) 266-7073
Sole ProprietorYes
Enumeration DateFebruary 25, 2008
Last NPPES UpdateDecember 17, 2025
NPPES CertifiedDecember 17, 2025
✔ NPI 1366611352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in MD · D0071811✔ Licensed in DC · MD30754
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5425 WISCONSIN AVE STE 810, Chevy Chase, MD 20815
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ida M Bergstrom M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 22, 2016 through June 22, 2028.

Opt-Out Effective DateJune 22, 2016
Opt-Out In Effect ThroughJune 22, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20815 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT J MARSHALL M.D.
Internal Medicine (Cardiovascular Disease)
5425 WISCONSIN AVE STE 810
CHEVY CHASE, MD 20815
Montgomery County (202) 266-7070

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 Ida Bergstrom's NPI number?

The NPI number for Ida Bergstrom is 1366611352. It was assigned to this individual provider in the NPPES registry on February 25, 2008.

Where is Ida Bergstrom located?

Ida Bergstrom practices at 5425 Wisconsin Ave Ste 810, Chevy Chase, MD 20815. The listed phone number is (202) 266-7070.

What is Ida Bergstrom's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ida Bergstrom enrolled in Medicare?

No. Ida Bergstrom has opted out of Medicare through June 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ida Bergstrom was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.