Physician Compare National (NPI:1508872938)

HEALTHCARE PROVIDER: PAUL ALLEN BERGFELDER MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1508872938
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567638141
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120103000418
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BERGFELDER
	Individual professional last name
Provider First Name	PAUL
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1915 CHESTER BLVD
	Group Practice or individual's line 1 address
City	RICHMOND
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	473741212
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150048
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	REID HOSPITAL & HEALTH CARE SERVICES
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y