NICOLE MARIE BERGMAN (OD) – Optometrist, NPI 1275272593

NICOLE MARIE BERGMAN (OD) is a healthcare provider. based in Bloomington, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 3789 (MN). The NPI Number for NICOLE MARIE BERGMAN (OD) is 1275272593

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE MARIE BERGMAN (OD)
NPI
1275272593
Phone
(952) 567-6125
Address
9801 DUPONT AVE S STE 425
Enumeration Date
3 June 2022
Last Update Date
3 June 2022

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
9528885800
Graduation Year
2022 (4 years ago)
PAC ID
9638558968
Group Practice PAC ID
4284524539
Professional Enrollment ID
I20220616002302
Address ID
MN554313200BL9801XSXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for NICOLE MARIE BERGMAN (OD)

  • 9801 DUPONT AVE S STE 425

    BLOOMINGTON, MN 554313873

    Phone: (952) 567-6125

    Fax: (952) 567-6176

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $341.

Total Amount is formed as General ($341) + Research ($0) + Ownership ($0) = $341.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: BIOTISSUE HOLDINGS, INC. ($141).

Total Amount

$341

General + Research + Ownership

Payments

9

Total payment records

General Amount

$341

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2022-06-16

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
I20220616002302IOptometryMNTBD

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 minutes8876$0
92014Established patient complete exam of visual system3838$0
92134Imaging of retina2726$0
92004New patient complete exam of visual system2323$0
99214Established patient office or other outpatient visit, 30-39 minutes1816$0
View full utilization report →

Insurance plans in this area (ZIP 55431)

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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: 4284524539View full group profile
NameSpecialtyState
O P H T H A L M O L O G YMN
O P T O M E T R YMN
O P T O M E T R YMN
O P H T H A L M O L O G YMN
O P H T H A L M O L O G YMN
O P H T H A L M O L O G YMN
-MN
O P T O M E T R YMN
O P T O M E T R YMN
Physician AssistantMN

Reviews

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Frequently asked questions

Does NICOLE MARIE BERGMAN (OD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — NICOLE MARIE BERGMAN (OD) uses 1275272593.
Is NICOLE MARIE BERGMAN (OD) still practicing?
NICOLE MARIE BERGMAN (OD) is currently listed as active in the public NPI registry.
What is NICOLE MARIE BERGMAN (OD)'s specialty?
The listing groups NICOLE MARIE BERGMAN (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
What address line appears for NICOLE MARIE BERGMAN (OD)?
NICOLE MARIE BERGMAN (OD)'s geographic hint is Bloomington, Minnesota in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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