Bethany Mulder, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OP60968552 Issued in WA

Practice address

605 S Coolidge St
Moses Lake, WA 98837-1893

Phone

(509) 765-0674

Fax

(509) 764-0344

NPI assigned

Mar 14, 2016

Last updated

Dec 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Hospitalist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grant County Public Hospital District 1Group PAC ID 9931095692, shared by 3 NPIs, 112 clinicians

Moses Lake Community Health CenterGroup PAC ID 1254235138, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assured Home Health Home health agency, Moses Lake, WA, CCN 507048
• Samaritan Hospital Hospital, Moses Lake, WA, CCN 500033
• Quincy Valley Medical Center Hospital, Quincy, WA, CCN 501320
• Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016
• Columbia Basin Hospital Hospital, Ephrata, WA, CCN 501317

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Moses Lake Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Moses Lake, WA
  • NPI 1699862813
  Medicare reassignment Care Compare group NPD
• Moses Lake Community Health Center

  dba Quincy Student Health and Wellness Center

  • Student Health Clinic/Center
  • Quincy, WA
  • NPI 1730756644
  NPD

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

• Central Washington Health Services Association

  dba Confluence Health

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1306883228
  Care Compare affiliation
• Grant County Public Hospital District #2

  • Critical Access Hospital
  • Quincy, WA
  • NPI 1164512083
  Care Compare affiliation
• Grant County Public Hospital District 1

  dba Samaritan

  • General Acute Care Hospital
  • Moses Lake, WA
  • NPI 1902818883
  Care Compare affiliation
• Grant County Public Hospital District 2

  dba Quincy Valley Medical Center

  • Land Ambulance
  • Quincy, WA
  • NPI 1851465660

  Hospital

  Care Compare affiliation
• Grant County Public Hospital District No. 3

  dba Columbia Basin Hospital

  • Critical Access Hospital
  • Ephrata, WA
  • NPI 1811979610
  Care Compare affiliation
• Washington Homecare and Hospice of Central Basin, LLC

  dba Assured Home Health

  • Home Health Agency
  • Moses Lake, WA
  • NPI 1720220908
  Care Compare affiliation

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1093176398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-765-0674",
            "fax_number": "509-764-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-765-0674",
            "fax_number": "509-764-0344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-814-2115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "888 Swift Blvd",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523514",
            "country_code": "US",
            "telephone_number": "509-946-4611",
            "fax_number": "509-942-2812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULDER",
        "first_name": "BETHANY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60968552",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP60968552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2134374",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moses Lake Sports Physical Therapy, PS
• Harold Scott Mounts, ARNP
• Zackery Muck
• Pegi Mueller, BA
• Haron E Mulamba, OTR
• Jamie Lea Mullenix
• Virginia Muniz-Gaytan, RN
• Nina Nacacia Murray, LMP
• Ben T Murrell, PA-C
• Murali K Nalluri, M.D.

• Internal Medicine Physician in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.