MR. DEANE BERGSRUD P.A. NPI 1124234455

NPI Information

  • NPI: 1124234455
  • Provider Name: MR. DEANE BERGSRUD, P.A.
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • Address: 4660 KENMORE AVE
    SUITE 900
    ALEXANDRIA, VA
    ZIP 22304
  • Phone: (703) 212-0700

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NPI Details

MR. Deane Bergsrud, P.A. is a physician assistant in Alexandria, VA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MR. Deane Bergsrud, P.A. NPI is 1124234455. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4660 KENMORE AVE
SUITE 900
ALEXANDRIA, VA
ZIP 22304-313
Phone: (703) 212-0700
Fax: (703) 212-0705

The enumeration date for this NPI number is 5/15/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant0110000120VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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