Individual provider Active NPI

Bernard J Betka, CRNA

  • Certified Registered Nurse Anesthetist
  • Midland, MI
National Provider Identifier
1063502797
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704177764 Issued in MI
Practice address
4005 Orchard Dr
Midland, MI 48670-0001
Phone
(989) 839-3000
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704177764 MI Primary

Addresses

Primary practice location

4005 Orchard Dr
Midland, MI 48670-0001

Mailing address

1302 E Illinois CT
Mt Pleasant, MI 48858-2967
Phone (989) 775-6499

Other identifiers 2

IdentifierTypeStateIssuer
BB177764OtherMIBLUE SHIELD
4397030MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120310000044 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234398207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan II PCGroup PAC ID 7911895164, 22 clinicians

Practice addresses (Care Compare)

4851 E Pickard St
Mt Pleasant, MI 48858-2029
Phone (989) 546-2170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Grayling Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients
Mymichigan Medical Center Midland CurrentSince May 13, 2002 Accepting new patients
Mymichigan Medical Center Midland Nurse Anesthetist, Certified Registered CurrentSince May 13, 2002 Accepting new patients
Midland Pathology Associates, PC Current Accepting new patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients

Locations

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

4005 Orch Dr
Midland, MI 48670
Phone (989) 839-3100

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4851 E Pickard St
Mt Pleasant, MI 48858
Phone (989) 772-3009

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

135 S Prospect St
Ypsilanti, MI 48198
Phone (734) 547-1060

L4355
Columbus, OH 43260

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063502797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 E ILLINOIS CT",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582967",
            "telephone_number": "989-775-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 ORCHARD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486700001",
            "telephone_number": "989-839-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETKA",
        "first_name": "BERNARD",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704177764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "BB177764",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4397030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.