Active NPI
William Richard Beltz, MD
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Williamsport, PA
National Provider Identifier
1104894930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- License
- MD019220E
- Practice address
- 1100 Grampian Blvd
Williamsport, PA 17701-1909 - Phone
- (570) 326-8550
- Fax
- (570) 326-8551
- NPI assigned
- Mar 9, 2006
- Last updated
- Oct 19, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 2083P0011X | MD019220E | PA | Primary |
| Vascular Surgery Physician | 2086S0129X | MD019220E | PA |
Addresses
Primary practice location
1100 Grampian Blvd
Williamsport, PA 17701-1909
Mailing address
1201 Grampian Blvd
Suite 1K
Williamsport, PA 17701-1900
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B35016 | Other | PA | HEALTHAMERICA |
| 1009016270002 | Medicaid | PA | |
| 818240 | Other | PA | FIRST PRIORITY HEALTH |
| 073991 | Other | PA | HIGHMARK BLUE SHIELD |
| 119183 | Other | PA | UNITEDHEALTHCARE |
| 5246319 | Other | PA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD019220E | PA | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1104894930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 GRAMPIAN BLVD",
"address_2": "SUITE 1K",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 GRAMPIAN BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011909",
"telephone_number": "570-326-8550",
"fax_number": "570-326-8551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELTZ",
"first_name": "WILLIAM",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0011X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
"state": "PA",
"license": "MD019220E",
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "PA",
"license": "MD019220E",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHAMERICA",
"identifier": "B35016",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009016270002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY HEALTH",
"identifier": "818240",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "073991",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTHCARE",
"identifier": "119183",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5246319",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.