Dr Jake Bergstrom, MD in Auburn, WA - Medicare Internal Medicine

Dr Jake Bergstrom, MD is a medicare enrolled "Internal Medicine" physician in Auburn, Washington. His current practice location is 17500 Se 392nd St, Auburn, Washington. You can reach out to his office (for appointments etc.) via phone at (253) 939-6648.

Dr Jake Bergstrom is licensed to practice in Washington (license number MD00020595) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1134289051.

Contact Information

	Dr Jake Bergstrom, MD
	17500 Se 392nd St, Auburn, WA 98092-9705
	(253) 939-6648
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Jake Bergstrom
Gender	Male
Speciality	Internal Medicine
Location	17500 Se 392nd St, Auburn, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134289051
Provider Enumeration Date: 12/11/2006
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 5294897906
Enrollment ID: I20081215000186

Medical Identifiers

Medical identifiers for Dr Jake Bergstrom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134289051	NPI	-	NPPES
9109BE	Other	WA	REGENCE BLUE SHIELD
1043009	Medicaid	WA
1107507	Medicaid	WA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	MD00020595 (Washington)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jake Bergstrom allows following entities to bill medicare on his behalf.

Entity Name	Muckleshoot Indian Tribe
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558448175 PECOS PAC ID: 5092724286 Enrollment ID: O20060417000580

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jake Bergstrom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jake Bergstrom, MD Po Box 570, Oakville, WA 98568 Ph: (360) 273-5504	Dr Jake Bergstrom, MD 17500 Se 392nd St, Auburn, WA 98092-9705 Ph: (253) 939-6648

Reviews and Comments

Internal Medicine Doctors in Auburn, WA

Eduardo Gil De Rubio, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 202 N Division St, Auburn, WA 98001 Phone: 253-833-7711
Dr. Robert Todd Middleton, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 202 N Division St, Ste 201, Auburn, WA 98001 Phone: 253-939-1230 Fax: 253-735-1211
Abdul R Siddiqui, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 202 N Division St Ste 301, Auburn, WA 98001 Phone: 253-288-3040
Dr. Krystoff J. Godlewski, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 202 N Division St, Plaza 2 Suite 201, Auburn, WA 98001 Phone: 253-939-1230 Fax: 253-735-6479
Iliana Domenica Micali, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 309 2nd St Se, Ste 100, Auburn, WA 98002 Phone: 253-333-8646
Dr. James Martin Wagner, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 202 N Division St, Plaza 2 Suite 201, Auburn, WA 98001 Phone: 253-939-1230
Madhavi Reddy Mandala, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 202 N Division St Ste 301, Auburn, WA 98001 Phone: 253-833-7256

Dr Jake Bergstrom, MD - Medicare Internal Medicine in Auburn, WA