EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1295376523

EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) is a healthcare provider. based in Tulsa, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PHYSICIAN ASSISTANT. They hold a License No. 4722 (OK). The NPI Number for EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) is 1295376523

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT)
NPI
1295376523
Phone
(918) 955-9302
Address
4337 E 57TH ST
Enumeration Date
8 October 2019
Last Update Date
4 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9184942200
Graduation Year
2021 (5 years ago)
PAC ID
7012301260
Group Practice PAC ID
5395234678
Professional Enrollment ID
I20220303001781
Address ID
OK741361902TU6161XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,797 PHYSICIAN ASSISTANT in OK

Provider Addresses for EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT)

  • 4337 E 57TH ST

    TULSA, OK 741354237

    Phone: (918) 955-9302

    Type: Mailing

  • 1417 W 78TH ST APT 1213

    TULSA, OK 741324633

    Phone: (918) 955-9302

    Type: Location

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: 2022-03-03

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
I20220303001781IPhysician AssistantOKTBD

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
99284Emergency department visit with moderate level of medical decision making4141$0
99285Emergency department visit with high level of medical decision making2020$0
99283Emergency department visit with low level of medical decision making1413$0
View full utilization report →

Insurance plans in this area (ZIP 74135)

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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: 5395234678View full group profile
NameSpecialtyState
Nurse PractitionerWI
Emergency MedicineTX
Physician AssistantOK
Emergency MedicineCA
Physician AssistantOK
Physician AssistantOK
Physician AssistantOK
Physician AssistantOK
Physician AssistantMO
Emergency MedicineID

Reviews

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Frequently asked questions

Can I cross-check EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) using NPI 1295376523?
NPI 1295376523 belongs to EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT); compare other details if you need extra assurance.
Is there an active status for EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT)?
For scheduling context, EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) is shown as active in the registry.
What clinical focus is listed for EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT)?
At a glance, EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT)?
Directory geography for EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) centers on Tulsa, Oklahoma.
When was this NPI issued?
Enumeration for EMILY MONTANA BERGERON (PHYSICIAN ASSISTANT) is noted as October 8, 2019 where the registry provides it.

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