NICOLE MARIE BERGMAN (PA-C) – Medical Physician Assistant, NPI 1639468184
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for NICOLE MARIE BERGMAN (PA-C)
815 COMMERCE DR
SUITE 100
PERRYSBURG, OH 435515255
Phone: (419) 872-4673
Fax: (419) 873-8329
Type: Mailing
702 COMMERCE DR
SUITE 100
PERRYSBURG, OH 435515239
Phone: (419) 872-4673
Fax: (419) 873-8329
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 167 Open Payments records for all available years, with a total value of $2,183.
Total Amount is formed as General ($2,183) + Research ($0) + Ownership ($0) = $2,183.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($664).
Total Amount
$2,183
General + Research + Ownership
Payments
167
Total payment records
General Amount
$2,183
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $664 |
| Dermavant Sciences, Inc. | $375 |
| GENZYME CORPORATION | $370 |
| Janssen Biotech, Inc. | $184 |
| E.R. Squibb & Sons, L.L.C. | $136 |
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: 2011-04-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110426000025 | I | Physician Assistant | OH | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43551)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | OH |
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