NPIMap

Individual provider Active NPI

Bethany Citerella, MD

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1073135141
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-11766 Issued in IA
Practice address
1111 6TH Ave
Des Moines, IA 50314-2613
Phone
(515) 643-8678
Fax
(515) 643-5802
NPI assigned
May 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-11766 IA Primary

Addresses

Primary practice location

1111 6TH Ave
Des Moines, IA 50314-2613

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-8678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030000844 LA Practitioner - Family PracticePractitioner - Emergency Medicine 7113358540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saline Emergency Group LLCGroup PAC ID 1153662598, 4 clinicians
CLHG-Winn, LLCGroup PAC ID 6002198736, 17 clinicians

Practice addresses (Care Compare)

301 W Boundary Ave
Winnfield, LA 71483-3427
Phone (318) 648-3014

301 W Boundary Ave B
Winn Wellness Clinic
Winnfield, LA 71483-3427
Phone (318) 209-4646

639 W Lafayette St
Winn Rural Health
Winnfield, LA 71483-3451
Phone (318) 648-3025

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R-11766IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Winn LLC Family Medicine CurrentSince Nov 22, 2023 Accepting new patients
Saline Emergency Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
CLHG-Winn, LLC Family Medicine CurrentSince Nov 22, 2023 Accepting new patients
CLHG-Winn, LLC Past Accepting new patients

Locations

639 W Lafayette St
Winnfield, LA 71483
Phone (318) 648-2220

301 W Boundary Ave
Ste B
Winnfield, LA 71483
Phone (318) 209-4646

301 W Boundary Ave
Winnfield, LA 71483
Phone (318) 628-2721

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: bethany.citerella.1@25133.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25133/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1073135141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-8678",
            "fax_number": "515-643-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142613",
            "telephone_number": "515-643-8678",
            "fax_number": "515-643-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITERELLA",
        "first_name": "BETHANY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-11766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.