Dr Derek Scott Bergeson, MD | |
1055 N 500 W, Attn Credentialing, Provo, UT 84604-8460 | |
(801) 354-8225 | |
(801) 418-0941 |
Full Name | Dr Derek Scott Bergeson |
---|---|
Gender | Male |
Speciality | Diagnostic Radiology |
Experience | 23 Years |
Location | 1055 N 500 W, Provo, Utah |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164641387 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 45556 (Colorado) | Secondary |
2085R0202X | Radiology - Diagnostic Radiology | 12767278-1205 (Utah) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Timpanogos Regional Hospital | Orem, UT | Hospital |
Jordan Valley Medical Center | West jordan, UT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Central Utah Clinic Pc | 7517868508 | 386 |
Entity Name | Central Utah Clinic Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
Mailing Address | Practice Location Address |
---|---|
Dr Derek Scott Bergeson, MD 1055 N 500 W, Attn Credentialing, Provo, UT 84604 Ph: (801) 354-8225 | Dr Derek Scott Bergeson, MD 1055 N 500 W, Attn Credentialing, Provo, UT 84604-8460 Ph: (801) 354-8225 |
Dr. Daniel Lyman Corey, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-225-6246 Fax: 801-225-1525 | |
Samuel Lynn Southam, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7850 Fax: 801-357-7626 | |
Scott D Valadez, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Suite 112, Provo, UT 84604 Phone: 801-812-4624 Fax: 801-812-4699 | |
Mark S Asay, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-373-7850 | |
Dalton H Wright, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Suite 112, Provo, UT 84604 Phone: 801-812-4624 Fax: 801-812-4699 | |
Justin Marshall, Radiology Medicare: Medicare Enrolled Practice Location: 1055 N 300 W Ste 104, Provo, UT 84604 Phone: 801-379-6700 Fax: 801-225-1525 |