KENNETH S BERGMAN (MD) – Radiation Oncology Physician, NPI 1669443032

KENNETH S BERGMAN (MD) is a healthcare provider. based in Tacoma, Washington. specializing in RADIATION ONCOLOGY. They hold the professional credentials MD. They hold a License No. MD00030100 (WA). The NPI Number for KENNETH S BERGMAN (MD) is 1669443032

Main info

Male
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH S BERGMAN (MD)
NPI
1669443032
Phone
(253) 627-6172
Address
314 MLK JR WAY
Enumeration Date
1 February 2006
Last Update Date
28 August 2012

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Secondary Phone
2532003166
Graduation Year
1990 (36 years ago)
PAC ID
3375520851
Group Practice PAC ID
9739443391
Professional Enrollment ID
I20040701001525
Address ID
WA983731659PU2940XMERI301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

184 RADIATION ONCOLOGY in WA

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Provider Addresses for KENNETH S BERGMAN (MD)

  • 314 MLK JR WAY

    STE 11

    TACOMA, WA 98405

    Phone: (253) 627-6172

    Fax: (253) 627-8792

    Type: Mailing

  • Saint Anthony Hospital Annex, 11511, Canterwood Boulevard Northwest, Canterwood, Gig Harbor, Pierce County, Washington, 98332, United States

    SUITE 50

    GIG HARBOR, WA 983325813

    Phone: (253) 851-5155

    Fax: (253) 851-5367

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $370.

Total Amount is formed as General ($370) + Research ($0) + Ownership ($0) = $370.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: PALETTE LIFE SCIENCES, INC. ($124).

Total Amount

$370

General + Research + Ownership

Payments

12

Total payment records

General Amount

$370

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

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: 2004-07-01

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
I20040701001525IRadiation OncologyWATBD

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
Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml9,970107$0
A9607Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie7,00023$0
77014Ct guidance for insertion of radiation therapy fields81781$0
G6015Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session72168$0
77336Continuing radiation therapy consultation per week18180$0
View full utilization report →

Insurance plans in this area (ZIP 98405)

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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: 9739443391View full group profile
NameSpecialtyState
Radiation OncologyWA

Reviews

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Frequently asked questions

Does KENNETH S BERGMAN (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KENNETH S BERGMAN (MD) uses 1669443032.
Does the file indicate KENNETH S BERGMAN (MD) is practicing under active NPI?
Directory data currently reports KENNETH S BERGMAN (MD) as active.
What is KENNETH S BERGMAN (MD)'s primary classification?
Radiation Oncology Physician is the headline specialty for KENNETH S BERGMAN (MD) here. Clinical services aligned with this taxonomy classification.
What address line appears for KENNETH S BERGMAN (MD)?
KENNETH S BERGMAN (MD)'s geographic hint is Tacoma, Washington in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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