Active NPI
Bettina Anne-Margaret Gaycken, M.D.
- Diagnostic Radiology Physician
- Panama City, FL
National Provider Identifier
1104087105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME133611
- Practice address
- 527 N Palo Alto Ave
Panama City, FL 32401-3639 - Phone
- (850) 747-4905
- Fax
- (850) 215-0469
- NPI assigned
- Jun 23, 2008
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 19155 | MS | |
| Diagnostic Radiology Physician | 2085R0202X | 43654 | TN | |
| Diagnostic Radiology Physician | 2085R0202X | ME133611 | FL | Primary |
Addresses
Primary practice location
527 N Palo Alto Ave
Panama City, FL 32401-3639
Mailing address
PO Box 1770
Panama City, FL 32402-1770
Phone (850) 747-4905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Tennessee, HSC, College of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
50 Humphreys Ctr Dr
Suite 23
Memphis, TN 38120-2369
Phone (901) 226-0810
Hospital & facility affiliations
- Baptist Memorial Hospital
- Baptist Memorial Hospital Tipton
- Methodist Hospitals of Memphis
- St Francis Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43654 | TN | MD | Pharmacist |
| ME133611 | FL | MD | Diagnostic Radiology Physician |
| 19155 | MS | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Womens Diagnostic Group PLLC | Diagnostic Radiology | Current | Accepting new patients |
Locations
50 Humphreys Center Dr
Ste 23
Memphis, TN 38120
Phone (901) 226-0810
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Memphis, TN
- NPI 1104922392
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1578527172
-
- General Acute Care Hospital
- Covington, TN
- NPI 1316901937
-
dba Le Bonheur Children's Hospital
- Children's Hospital
- Memphis, TN
- NPI 1386709871
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
-
dba Le Bonheur Children's Hospital - Germantown
- Children's Hospital
- Germantown, TN
- NPI 1649654450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1104087105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1770",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324021770",
"telephone_number": "850-747-4905",
"fax_number": "850-215-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 N PALO ALTO AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324013639",
"telephone_number": "850-747-4905",
"fax_number": "850-215-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYCKEN",
"first_name": "BETTINA",
"middle_name": "ANNE-MARGARET",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MS",
"license": "19155",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "43654",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME133611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.