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NICOLE MARIE BERGMAN PA-C
NPI 1639468184
Physician Assistant - Medical in Perrysburg, OH

Active since April 05, 2011PECOS EnrolledAccepts Medicare Assignment
702 COMMERCE DR, SUITE 100, PERRYSBURG, OH 43551(419) 872-4673(419) 873-8329 Get Directions Write a Review

NPPES record last updated: November 7, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nicole Marie Bergman Pa-c NPPES

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

NICOLE MARIE BERGMAN PA-C (NPI 1639468184) is an individual medical provider in Perrysburg, Ohio, licensed in Ohio (50.003246) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1639468184
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameNICOLE MARIE BERGMANCredential: PA-C
Location Address702 COMMERCE DR, SUITE 100Perrysburg, OH 43551-5239
Mailing Address815 Commerce Dr, Suite 100Perrysburg, OH 43551-5255 · (419) 872-4673 · Fax (419) 873-8329
Phone(419) 872-4673
Fax(419) 873-8329
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateApril 5, 2011
Last NPPES UpdateNovember 7, 2016
✔ NPI 1639468184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in OH · 50.003246
702 COMMERCE DR, Perrysburg, OH 43551
Open in Google Maps ↗

Other Identifiers 3

Other9344881OH · Medicare Group
Medicare PINH065730OH
OtherDD1846OH · Railroad Medicare Group

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Marie Bergman Pa-c 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 ID1951586544
PECOS Enrollment IDI20110426000025
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.

Other Providers at the Same Location NPPES 7

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

DR. LESLIE JOSEPH DOMINI M.D.
Family Medicine
702 COMMERCE DR, STE 160
PERRYSBURG, OH 43551
Wood County (419) 872-7600
MICHAEL A HEALY M.D.
Neurological Surgery
702 COMMERCE DR, STE100
PERRYSBURG, OH 43551
Wood County (419) 794-3475
PERRYSBURG FAMILY PHYSICIANS LLC
Family Medicine
702 COMMERCE DR, SUITE 160
PERRYSBURG, OH 43551
Wood County (419) 872-7600
CATHERINE G CARRIGAN MD
Family Medicine
702 COMMERCE DR, SUITE 160
PERRYSBURG, OH 43551
Wood County (419) 872-7600
DR. ROBERT MARC DONAWA M.D.
Family Medicine
702 COMMERCE DR, STE 160
PERRYSBURG, OH 43551
Wood County (419) 872-7600
MICHAEL ALLEN NEISWANDER MD
Family Medicine
702 COMMERCE DR, SUITE 160
PERRYSBURG, OH 43551
Wood County (419) 872-7600
NEUROSURGICAL NETWORK, INC.
Neurological Surgery
702 COMMERCE DR, SUITE 100
PERRYSBURG, OH 43551
Wood County (419) 794-3475

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 Nicole Bergman's NPI number?

The NPI number for Nicole Bergman is 1639468184. It was assigned to this individual provider in the NPPES registry on April 5, 2011.

Where is Nicole Bergman located?

Nicole Bergman practices at 702 Commerce Dr Suite 100, Perrysburg, OH 43551. The listed phone number is (419) 872-4673.

What is Nicole Bergman's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Nicole Bergman enrolled in Medicare?

Yes. Nicole Bergman 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.

When was this NPI record last updated?

The NPPES record for Nicole Bergman was last updated on November 7, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.