Mallorie A. Bergstrom, PA-C
NPI 1730490012ActiveIndividual· Physician Assistant· Wauwatosa, WI
Physician Assistant (PA-C) with Ascension Medical Group-Southeast Wisconsin Inc and 1 other group, practicing in Wauwatosa, Wisconsin. 130 Medicare patients in 2024, $12,199 paid; nearly all of their 346 Part D prescriptions were generic (98%). Boston Scientific Corporation reported $137.92 in payments in 2025, mostly food and beverage. Lists Ascension All Saints Hospital and 1 other hospital as hospital affiliations.
Overview
| NPI | 1730490012 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Jul 1, 2010 |
| Last updated in NPPES | May 2, 2022 |
| Certified by provider | May 2, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 2591-23 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 130 |
|---|---|
| Services billed | 254 across 12 procedure codes |
| Paid by Medicare | $12,199 |
Part D prescriptions in 2024
| Prescriptions (claims) | 346 · 577 30-day fills |
|---|---|
| Patients | 117 |
| Total drug cost | $10,822 |
| Generic share | 98% of claims |
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Ascension Medical Group-Southeast Wisconsin IncBrookfield, WI · 545 clinicians
- Premier Radiology Wisconsin LLCMount Pleasant, WI · 106 clinicians
Hospital affiliations
- Ascension All Saints HospitalRacine, WI
- Ascension Columbia St Marys Hospital MilwaukeeMilwaukee, WI
Industry payments (Open Payments)
- 2025$137.92 · 1 payment from 1 company
- 2024$15.53 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Boston Scientific Corporation | $137.92 | 1 |
What the 2025 payments were for
- Food and Beverage$137.92 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Physician Assistant providers in Wauwatosa
- 1245938596
- 1417471962
- 1952378630
- 1467014514
- 1851939623
- 1568584795
- 1265486120
- 1932732484
- 1467961599
- 1316704075
- 1972286532
- 1912630641