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JEFFREY ROBERT BERGSTROM MSW LCSW MPA
NPI 1558840850
Social Worker - Clinical in Mullan, ID

Active since August 08, 2018PECOS Enrolled
379 2ND STREET, MULLAN, ID 83846(307) 264-0114 Get Directions Write a Review

NPPES record last updated: December 27, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Dec 27, 2024, Aug 18, 2023, Jul 11, 2019 and 1 more (4 updates tracked since 2018).

About Jeffrey Robert Bergstrom Msw Lcsw Mpa NPPES

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

JEFFREY ROBERT BERGSTROM MSW LCSW MPA (NPI 1558840850) is an individual clinical provider in Mullan, Idaho, licensed in Idaho (40757) and active in the NPI registry since August 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558840850
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJEFFREY ROBERT BERGSTROMCredential: MSW LCSW MPA
Location Address379 2ND STREETMullan, ID 83846
Mailing AddressPo Box 444Mullan, ID 83846-0444 · (208) 446-6758
Phone(307) 264-0114
Sole ProprietorYes
Enumeration DateAugust 8, 2018
Last NPPES UpdateDecember 27, 20244 updates tracked since enumeration
NPPES CertifiedDecember 19, 2024
✔ NPI 1558840850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in ID · 40757✔ Licensed in CA · 100963✔ Licensed in HI · 4686✔ Licensed in MT · 49993
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
379 2ND STREET, Mullan, ID 83846
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA, Mountain Health CO-OP.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey Robert Bergstrom Msw Lcsw Mpa 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.

Medicare Billing Reassignment

Medicare enrollment records show Jeffrey Bergstrom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Health Centers Of San Diego, Inc.
1,015 mi
Federally Qualified Health Center (FQHC)
525 E MAIN ST
El Cajon, CA 92020
  • Reassigned Medicare billing, California enrollment
  • 1,100 clinicians in this Medicare group
NPI 1932561198 (619) 515-2498

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 83846 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
$0.00 typical visit price
range $52.44 – $160.17
Typical copayment $0.00 (range $13.11 – $40.04)
Most-billed visit code NA
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
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 Jeffrey Bergstrom's NPI number?

The NPI number for Jeffrey Bergstrom is 1558840850. It was assigned to this individual provider in the NPPES registry on August 8, 2018.

Where is Jeffrey Bergstrom located?

Jeffrey Bergstrom practices at 379 2nd Street, Mullan, ID 83846. The listed phone number is (307) 264-0114.

What is Jeffrey Bergstrom's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jeffrey Bergstrom enrolled in Medicare?

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

Which organization bills Medicare for Jeffrey Bergstrom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Bergstrom reassigns Medicare benefits to Family Health Centers Of San Diego, Inc. (El Cajon, CA). The 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 Jeffrey Bergstrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeffrey Bergstrom accept?

Health plans from HMSA and Mountain Health CO-OP list Jeffrey Bergstrom 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 Jeffrey Bergstrom was last updated on December 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.