LISA A BERGERON (M.D.) – Pediatrics Physician, NPI 1801890355
Pediatrics Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for LISA A BERGERON (M.D.)
1234, East Dupont Road, Fort Wayne, Allen County, Indiana, 46825, United States
SUITE 1
FORT WAYNE, IN 468251545
Phone: (260) 373-9700
Fax: (260) 373-9740
Type: Mailing
6108, Maplecrest Road, Fort Wayne, Allen County, Indiana, 46835, United States
FORT WAYNE, IN 468352524
Phone: (260) 486-3300
Fax: (260) 486-3600
Type: Location
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 468451701
Phone:
Type: Mailing
11115 PARKVIEW PLAZA DR
FORT WAYNE, IN 468451701
Phone: (260) 266-5400
Fax: (260) 266-5405
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $108.
Total Amount is formed as General ($108) + Research ($0) + Ownership ($0) = $108.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Corium, LLC ($35).
Total Amount
$108
General + Research + Ownership
Payments
7
Total payment records
General Amount
$108
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Corium, LLC | $35 |
| Otsuka America Pharmaceutical, Inc. | $28 |
| Blueprint Medicines Corporation | $24 |
| Neos Therapeutics, LP | $21 |
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: 2009-03-30
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 |
|---|---|---|---|---|
| I20090330000489 | I | Pediatric Medicine | IN | 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 46825)
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