Debra L Bergstrom (NPI# 1780670398, PAC ID# 0547258733) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1780670398 |
| PAC ID by PECOS | 0547258733 |
| Professional Enrollment ID | I20090624000131 |
| Full Name | Debra L Bergstrom |
| Organization Legal Name | ARIZONA SKIN AND LASER THERAPY INSTITUTE LTD |
| Address |
4001 E Baseline Rd Suite 202 Gilbert AZ 85234-2735 |
| Phone Number | 4808440510 |
| Gender | F |
| Graduation Year | 1995 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6204720626 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 030062 | SUMMIT HEALTHCARE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 4001 E Baseline Rd, Suite 202, Gilbert, AZ 85234-2735 | 4808440510 | ARIZONA SKIN AND LASER THERAPY INSTITUTE LTD |
| 1500 S White Mountain Rd, Suite 401, Show Low, AZ 85901-7117 | 9285372550 | ARIZONA SKIN AND LASER THERAPY INSTITUTE LTD |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 62% | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 43% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_337_overall | Tuberculosis (TB) Prevention for Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier | 83% | |
| MIPS_EC_431_overall | Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 68% |
| Organization Legal Name | ARIZONA SKIN AND LASER THERAPY INSTITUTE LTD |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edward M Galiczynski | Dermatology | Arizona Skin and Laser Therapy Institute Ltd | 2224 W Northern Ave, Suite D300, Phoenix, AZ 85021-5099 |
| William J Waldo | General Surgery | Arizona Skin and Laser Therapy Institute Ltd | 1500 S White Mountain Rd, Suite 401, Show Low, AZ 85901-7117 |
| Marlene Wright | Nurse Practitioner | Arizona Skin and Laser Therapy Institute Ltd | 6644 E Baseline Rd, Suite 102, Mesa, AZ 85206-4439 |
| Glenn L Zellman | Dermatology | Arizona Skin and Laser Therapy Institute Ltd | 2224 W Northern Ave, Suite D300, Phoenix, AZ 85021-5099 |
| John A Ebner | Dermatology | Arizona Skin and Laser Therapy Institute Ltd | 2224 W Northern Ave, Suite D300, Phoenix, AZ 85021-5099 |
| Tirsa C Quartullo | Nurse Practitioner | Arizona Skin and Laser Therapy Institute Ltd | 2224 W Northern Ave, Suite D300, Phoenix, AZ 85021-5099 |
| Veronica K Dowling | Orthopedic Surgery | Arizona Skin and Laser Therapy Institute Ltd | 1500 S White Mountain Rd, Suite 401, Show Low, AZ 85901-7117 |
| Karla M Horton | Physician Assistant | Arizona Skin and Laser Therapy Institute Ltd | 2224 W Northern Ave, Suite D300, Phoenix, AZ 85021-5099 |
| Holly N Nichols | Nurse Practitioner | Arizona Skin and Laser Therapy Institute Ltd | 2224 W Northern Ave, Suite D300, Phoenix, AZ 85021-5099 |
| Michael L Crandall | Dermatology | Arizona Skin and Laser Therapy Institute Ltd | 2224 W Northern Ave, Suite D300, Phoenix, AZ 85021-5099 |
| Street Address |
4001 E BASELINE RD SUITE 202 |
| City | GILBERT |
| State | AZ |
| Zip | 85234-2735 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joshua Thomas Cady | Podiatry | Comprehensive Interventional Care Centers, Pllc | 4001 E Baseline Rd, Suite 107, Gilbert, AZ 85234-2744 |
| Michael C Switzer | Diagnostic Radiology | Comprehensive Interventional Care Centers, Pllc | 4001 E Baseline Rd, Suite 107, Gilbert, AZ 85234-2744 |
| Mitchell T Gadow | Family Medicine | Cigna Healthcare of Arizona Inc | 4001 E Baseline Rd, 107 Cmg Gilber Healthcare Center, Gilbert, AZ 85234-2744 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Haley Gann | Registered Dietitian Or Nutrition Professional | Eating for Life, LLC | 3820 E Leah Ct, Gilbert, AZ 85234-0013 |
| Aida E Amado | Nurse Practitioner | Banner Cancer Center Specialists LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Michelle Branton | Nurse Practitioner | Banner Cancer Center Specialists LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Ala Eddin Samir Sagar | Pulmonary Disease | Banner Cancer Center Specialists LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Andrew M Weinberg | Gastroenterology | Banner Cancer Center Specialists LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Reeshma S Mohammed | Nurse Practitioner | Banner Cancer Center Specialists LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Marwan M Oleiwi | Internal Medicine | Banner Hospital Based Physicians Arizona LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Tessa Meyer | Nurse Practitioner | Banner Cancer Center Specialists LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Karthik R Donuur | Internal Medicine | Banner Hospital Based Physicians Arizona LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Rosemary Bloom | Physician Assistant | Banner Cancer Center Specialists LLC | 1900 N Higley Rd, Gilbert, AZ 85234-1604 |
| Find all physicians in zip 85234 | |||
| City | GILBERT |
| Zip Code | 85234 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GILBERT + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Debra L Bergstrom.
| 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.