Lisa Marie Bergeron (NPI# 1366715179, PAC ID# 0143480350) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1366715179 |
| PAC ID by PECOS | 0143480350 |
| Professional Enrollment ID | I20120327000056 |
| Full Name | Lisa Marie Bergeron |
| Organization Legal Name | COMMUNITY HEALTH SERVICES INC |
| Address |
500 Albany Ave Hartford CT 06120-2508 |
| Phone Number | 8602499625 |
| Gender | F |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3870564172 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070005 | WATERBURY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 500 Albany Ave, Hartford, CT 06120-2508 | 8602499625 | COMMUNITY HEALTH SERVICES INC |
| 1625 Straits Tpke, Suite 110, Middlebury, CT 06762-1836 | 2037588107 | PROSPECT CT MEDICAL FOUNDATION, INC. |
| Organization Legal Name | COMMUNITY HEALTH SERVICES INC |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle J Cho | Physician Assistant | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Rushickah Chin | Nurse Practitioner | Community Health Services Inc | 503 Windsor Ave, Suite 511, Windsor, CT 06095-4015 |
| Olubukola O Awe | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Maria Elena Slajda | Nurse Practitioner | Community Health Services Inc | 503 Windsor Ave, Suite 511, Windsor, CT 06095-4015 |
| Kelly S Sullivan | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Sherwin M Tucker | Podiatry | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Kerry-ann Mcpherson | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Jacqueline Nicole Perez | Physician Assistant | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Jaime Kweon | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Sonia T Shubert | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Street Address |
500 ALBANY AVE |
| City | HARTFORD |
| State | CT |
| Zip | 06120-2508 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle J Cho | Physician Assistant | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Olubukola O Awe | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Kelly S Sullivan | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Sherwin M Tucker | Podiatry | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Kerry-ann Mcpherson | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Jacqueline Nicole Perez | Physician Assistant | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Jaime Kweon | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Sonia T Shubert | Nurse Practitioner | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Elaine S Hamilton | Registered Dietitian Or Nutrition Professional | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Melissa D Bellanfante | Clinical Social Worker | Community Health Services Inc | 500 Albany Ave, Hartford, CT 06120-2508 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kemmarie C Beal | Nurse Practitioner | 3580 Main St, Suite G, Hartford, CT 06120-1121 | |
| Wanda Serrano-miller | Clinical Social Worker | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Rebekah R Hafford | Clinical Social Worker | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Carole L Montano | Nurse Practitioner | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Mary Ann Rodriguez | Nurse Practitioner | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Giang Vo | Clinical Social Worker | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Bonafacia Lebron | Clinical Social Worker | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Yvonne E Acosta-martinez | Clinical Social Worker | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Denise Y Frank | Clinical Social Worker | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Patricia Pollicina | Clinical Social Worker | Hartford Community Mental Health Center Inc. | 2550 Main St, Suite 3, Hartford, CT 06120-1936 |
| Find all physicians in zip 06120 | |||
| City | HARTFORD |
| Zip Code | 06120 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | HARTFORD + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.