Dr Timothy Bergan, DO is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in Oshkosh, Wisconsin. His current practice location is
855 N Westhaven Dr, Oshkosh, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 303-8700.
Dr Timothy Bergan is licensed to practice in Wisconsin (license number 67044) 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 1194922864.
Physician's Profile
| Full Name | Dr Timothy Bergan |
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| Gender | Male |
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| Speciality | Preventive Medicine - Occupational Medicine |
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| Location | 855 N Westhaven Dr, Oshkosh, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1194922864
- Provider Enumeration Date: 06/27/2007
- Last Update Date: 10/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 7810267713
- Enrollment ID: I20170726001485
Medical Identifiers
Medical identifiers for Dr Timothy Bergan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194922864 | NPI | - | NPPES |
| 100068473 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083X0100X | Preventive Medicine - Occupational Medicine | 67044 (Wisconsin) | 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 Timothy Bergan allows following entities to bill medicare on his behalf.
| Entity Name | Aurora Medical Group, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427271378
PECOS PAC ID: 6709794258
Enrollment ID: O20031105000725 |
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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 Timothy Bergan 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 Timothy Bergan, DO
855 N Westhaven Dr,
Oshkosh, WI 54904-7668
Ph: (920) 303-8700 | Dr Timothy Bergan, DO
855 N Westhaven Dr,
Oshkosh, WI 54904-7668
Ph: (920) 303-8700 |
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