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LISA A BERGERON M.D.
NPI 1801890355
Pediatrics in Fort Wayne, IN

Active since June 10, 2005PECOS Enrolled
11115 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845(260) 266-5400(260) 266-5405 Get Directions Write a Review

NPPES record last updated: December 20, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Lisa A Bergeron M.d. NPPES

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

LISA A BERGERON M.D. (NPI 1801890355) is an individual pediatrics provider in Fort Wayne, Indiana, licensed in Indiana (01043876A) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801890355
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameLISA A BERGERONCredential: M.D.
Location Address11115 PARKVIEW PLAZA DRFort Wayne, IN 46845-1701
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Phone(260) 266-5400
Fax(260) 266-5405
Sole ProprietorNo
Enumeration DateJune 10, 2005
Last NPPES UpdateDecember 20, 2022
NPPES CertifiedDecember 20, 2022
✔ NPI 1801890355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in IN · 01043876A✔ Licensed in OH · 35065206
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
11115 PARKVIEW PLAZA DR, Fort Wayne, IN 46845
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Other Identifiers 2

Medicaid200037410IN
Other000000602350IN · Anthem

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa A Bergeron 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.

Medicare Billing Reassignments

2

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

Alliance Health Centers Inc.
5.9 mi
Federally Qualified Health Center (FQHC)
3320 N CLINTON ST
Fort Wayne, IN 46805
  • Reassigned Medicare billing, Indiana enrollment
  • 63 clinicians in this Medicare group
NPI 1528875358 (260) 266-0780
Bowen Health Inc
9.6 mi
Federally Qualified Health Center (FQHC)
201 E RUDISILL BLVD
Fort Wayne, IN 46806
  • Reassigned Medicare billing, Indiana enrollment
  • 260 clinicians in this Medicare group
NPI 1023668183 (800) 342-5653

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 46845 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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 20

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

DR. MELISSA S RICE D.O.
Pediatrics (Neonatal-Perinatal Medicine)
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 672-6443
KRISTEN N AZZUE
Physician Assistant
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-5400
DR. WIN BOON M.D.
Pediatrics (Neonatal-Perinatal Medicine)
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 672-4000
DR. RAVI KUDUMULA M.D.
Pediatrics (Neonatal-Perinatal Medicine)
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 672-6400
CHRISTEN A MERKLER CNP
Nurse Practitioner
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 672-6400
KRISTEN DETTMER PNP
Nurse Practitioner
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-5400
ROWANN HASSAN
Nurse Practitioner
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-5400
MRS. VIVIAN L APPIARIUS NP
Nurse Practitioner
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-5400

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 Lisa Bergeron's NPI number?

The NPI number for Lisa Bergeron is 1801890355. It was assigned to this individual provider in the NPPES registry on June 10, 2005.

Where is Lisa Bergeron located?

Lisa Bergeron practices at 11115 Parkview Plaza Dr, Fort Wayne, IN 46845. The listed phone number is (260) 266-5400.

What is Lisa Bergeron's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Lisa Bergeron enrolled in Medicare?

Yes. Lisa Bergeron is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lisa Bergeron's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Bergeron reassigns Medicare benefits to 2 organizations: Alliance Health Centers Inc. (Fort Wayne, IN) and Bowen Health Inc (Fort Wayne, IN). 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 Lisa Bergeron's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Bergeron accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Lisa Bergeron 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 Lisa Bergeron was last updated on December 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.