Charles A. Bergstrom, M.D.
NPI 1104886662ActiveIndividual· Family Medicine· Fayetteville, GA
Family Medicine (M.D.) in Fayetteville, Georgia, trained at University of Illinois College of Med (Chi/Peor/Rock/Chm-Urb) (class of 1984). 212 Medicare patients in 2024, $33,826 paid; nearly all of their 232 Part D prescriptions were generic (95%). Boston Scientific Corporation reported $59.90 in payments in 2024, mostly food and beverage.
Overview
| NPI | 1104886662 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | Mar 27, 2006 |
| Last updated in NPPES | Dec 30, 2021 |
| Certified by provider | Dec 30, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 033030 | GA |
| Specialist | 174400000X | 033030 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Family Practice (GA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 212 |
|---|---|
| Services billed | 389 across 5 procedure codes |
| Paid by Medicare | $33,826 |
Part D prescriptions in 2024
| Prescriptions (claims) | 232 · 238 30-day fills |
|---|---|
| Patients | 40 |
| Total drug cost | $4,878 |
| Generic share | 95% of claims |
Education and affiliations
| Medical school | University of Illinois College of Med (Chi/Peor/Rock/Chm-Urb) |
|---|---|
| Graduation year | 1984 |
| Medicare specialty | Family Practice |
Medical group
- Privia Medical Group of Georgia LLCFayetteville, GA · 462 clinicians
Industry payments (Open Payments)
- 2024$59.90 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Boston Scientific Corporation | $59.90 | 1 |
What the 2024 payments were for
- Food and Beverage$59.90 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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