TYANNA BERGERON NP
NPI 1891257630
Nurse Practitioner in Fulton, NY
About Tyanna Bergeron Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TYANNA BERGERON NP (NPI 1891257630) is an individual nurse practitioner in Fulton, New York, licensed in New York (F03190068) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tyanna Bergeron Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Tyanna Bergeron reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Cortland, NY 13045
- Reassigned Medicare billing, New York enrollment
- 37 clinicians in this Medicare group
Bend, OR 97701
- Reassigned Medicare billing, Oregon enrollment
- 11 clinicians in this Medicare group
West Linn, OR 97068
- Reassigned Medicare billing, Oregon enrollment
- 3 clinicians in this Medicare group
Coquille, OR 97423
- Reassigned Medicare billing, Oregon enrollment
- 71 clinicians in this Medicare group
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 13069 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FULTON, NY 13069
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 Tyanna Bergeron's NPI number?
The NPI number for Tyanna Bergeron is 1891257630. It was assigned to this individual provider in the NPPES registry on April 2, 2019.
Where is Tyanna Bergeron located?
Tyanna Bergeron practices at 522 S 4th St, Fulton, NY 13069. The listed phone number is (155) 923-9303.
What is Tyanna Bergeron's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Tyanna Bergeron enrolled in Medicare?
Yes. Tyanna Bergeron is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Tyanna Bergeron's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tyanna Bergeron reassigns Medicare benefits to 4 organizations: Pons Physician Services, PLLC (Cortland, NY), Oregon Vascular Specialists LLC (Bend, OR), Dermatology Solutions LLC (West Linn, OR) and Coquille Valley Hospital District (Coquille, OR). 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 Tyanna Bergeron's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tyanna Bergeron accept?
Health plans from Moda Health Plan, Inc. list Tyanna 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 Tyanna Bergeron was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Tyanna Bergeron, NP · NPI 1891257630
Nurse Practitioner physician in Fulton, New York. Individual provider, active in the CMS NPPES registry since April 2, 2019.
## Identity
- **NPI:** 1891257630 (Entity type: Individual)
- **Enumerated:** April 2, 2019
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** F03190068 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 522 S 4TH ST, Fulton, NY 13069-2946
- **Phone:** (155) 923-9303
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Pons Physician Services, PLLC (NPI 1457732554, Cortland, NY); Oregon Vascular Specialists LLC (NPI 1669917167, Bend, OR); Dermatology Solutions LLC (NPI 1508271198, West Linn, OR); Coquille Valley Hospital District (NPI 1730223967, Coquille, OR) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 11, 2019
- **Other identifiers:** Other 14421177
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Source: [NPI Profile](https://npiprofile.com/npi/1891257630) · Data from the CMS NPPES public registry.