MEDICARE: JAMES A BERGANT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	0414406	KS
2	208800000X	Urology Physician	105379	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	340016718	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18853091	OTHER		BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255380754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES A BERGANT MD

Provider Business Mailing Address
First Line	:	7611 STATE LINE RD
Second Line	:	STE240
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-6801
Country	:	US
Telephone Number	:	816-363-1155
Fax Number	:	816-363-1149

Provider Business Practice Location Address
First Line	:	7611 STATE LINE RD
Second Line	:	STE240
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-6801
Country	:	US
Telephone Number	:	816-363-1155
Fax Number	:	816-363-1149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	10/24/2011

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Directions to “ JAMES A BERGANT MD” Practice Location

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