KATELYN MARIE BERGERON (PA-C) – Physician Assistant, NPI 1710244405

KATELYN MARIE BERGERON (PA-C) is a healthcare provider. based in Brighton, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601006363 (MI). The NPI Number for KATELYN MARIE BERGERON (PA-C) is 1710244405

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
KATELYN MARIE BERGERON (PA-C)
NPI
1710244405
Phone
(810) 227-9510
Address
8001 CHALLIS RD
Enumeration Date
18 April 2012
Last Update Date
27 June 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8102279510
Graduation Year
2012 (14 years ago)
PAC ID
0749436509
Group Practice PAC ID
3779496856
Professional Enrollment ID
I20120809000678
Address ID
MI481167446BR8001XRDXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:14State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

Provider Addresses for KATELYN MARIE BERGERON (PA-C)

  • 8001 CHALLIS RD

    BRIGHTON, MI 481167446

    Phone: (810) 227-9510

    Type: Location

  • 3621 S STATE ST

    ANN ARBOR, MI 481081633

    Phone: (734) 647-5299

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-08-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120809000678IPhysician AssistantMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes229201$0
99214Established patient office or other outpatient visit, 30-39 minutes8375$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit7373$0
View full utilization report →

Insurance plans in this area (ZIP 48116)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779496856View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YFL
Physical Medicine And RehabilitationMI
A N E S T H E S I O L O G YMI
Internal Medicine, Pediatric MedicineIL
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

Is there an official ID for KATELYN MARIE BERGERON (PA-C) in U.S. healthcare records?
The official identifier for KATELYN MARIE BERGERON (PA-C) is NPI 1710244405.
Would KATELYN MARIE BERGERON (PA-C) appear as active to a payer?
You can treat KATELYN MARIE BERGERON (PA-C) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is KATELYN MARIE BERGERON (PA-C)?
KATELYN MARIE BERGERON (PA-C) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Is KATELYN MARIE BERGERON (PA-C) located near Brighton?
KATELYN MARIE BERGERON (PA-C) currently maps to Brighton, Michigan in this extract.
When was this NPI issued?
Enumeration for KATELYN MARIE BERGERON (PA-C) is noted as April 18, 2012 where the registry provides it.

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