Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Emily Montana Bergeron, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1295376523

Emily Montana Bergeron, PHYSICIANASSISTANT is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2021, 5 years ago. Practices with Ies ER Oklahoma LLC, a 128-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
5
Licensed in
OK
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1417 W 78th St Apt 1213
Tulsa, OK 74132-4633
Phone: (918) 955-9302
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 4722 (OK)

Record details

NPI number1295376523
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedOctober 8, 2019
Last updated in NPPESJanuary 4, 2022
Certification dateJanuary 4, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ies Er Oklahoma Llc — 128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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