NPIMap

Individual provider Active NPI

Renee Marie Betancourt, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1104111830
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD455600 Issued in PA
Practice address
51 N 39TH St
7TH FLR Mutch Building
Philadelphia, PA 19104-2640
Phone
(215) 662-8949
NPI assigned
Jun 10, 2011
Last updated
Aug 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD455600 PA Primary

Addresses

Primary practice location

51 N 39TH St
7TH FLR Mutch Building
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH St
7TH FLR Mutch Building
Philadelphia, PA 19104-2640
Phone (215) 662-8949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150902001466 PA Practitioner - Family Practice 5890926414 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3600 Civic Ctr Blvd
3E
Philadelphia, PA 19104-4310

3701 Market St
Philadelphia, PA 19104-5502
Phone (215) 662-2250

3737 Market St
Philadelphia, PA 19104-5545
Phone (215) 662-8777

3801 Filbert St
Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD455600PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
Trustees of the University of Pennsylvania Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Greater Philadelphia Health Action Inc. Current Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Greater Philadelphia Health Action, Inc. CurrentSince Dec 1, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 2, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 24, 2015 Accepting new patients
Greater Philadelphia Health Action Inc. CurrentSince Dec 1, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 24, 2015 Accepting new patients
Greater Philadelphia Health Action Inc. Family Medicine Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

1401 S 31st St
Philadelphia, PA 19146
Phone (215) 755-7700

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

3737 Market St
Fl 9
Philadelphia, PA 19104
Phone (215) 294-9284

432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000

5000 Woodland Ave
Philadelphia, PA 19143
Phone (215) 726-9807

51 N 39th St
Fl 7
Philadelphia, PA 19104
Phone (215) 662-8949

5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700

Interoperability endpoints

  • Direct secure messaging: renee.betancourtmd.p1@direct.gpha.nextgenshare.com

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1104111830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "7TH FLR MUTCH BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "7TH FLR MUTCH BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD455600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.