ELIZA A BERGSTROM, CAA — NPI 1801156385 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant in MADISON, WI)

CMS-1500 Box 24J / 33a • NPI

1801156385

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

367H00000X (CMS 32)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant

Box 32 Service Location & ZIP+4

600 HIGHLAND AVE, MADISON, WI, 53792-0001

✓ 9-Digit EDI 837 ZIP+4 (53792-0001)

Practice Phone & Referral Fax

(608) 263-8100

Fax: (608) 263-0575

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1801156385 (ELIZA A BERGSTROM, CAA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1801156385` (NPI-1 Individual Practitioner)
Provider / Legal Name	ELIZA A BERGSTROM, CAA
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant NUCC Code: `367H00000X` (Anesthesiologist Assistant)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	600 HIGHLAND AVE, MADISON, WI, 53792-0001
Practice Telephone / Fax	Tel: (608) 263-8100 \| Fax: (608) 263-0575
Administrative Mailing Address	7974 UW HEALTH CT, MIDDLETON, WI, 53562-5531
Enumeration & Last Sync	Enumerated: 2012-05-18 \| CMS Record Updated: 2025-02-04

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

600 HIGHLAND AVE, MADISON, WI, 53792-0001

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Plain-English Taxonomy & CMS Crosswalk (367H00000X)

What Does Taxonomy Code 367H00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367H00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 32 (Anesthesiology Assistant)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Anesthesiologist Assistant for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ELIZA A BERGSTROM, CAA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`367H00000X` — Anesthesiologist Assistant Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Anesthesiologist Assistant	State: WI \| License: `23` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ELIZA A BERGSTROM, CAA (NPI #1801156385)