Bethann Mahoney, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

OS12407 Issued in FL

Practice address

100 S Harbor City Blvd
Melbourne, FL 32901-1319

Phone

(321) 259-1662

Fax

(321) 259-1223

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Bethann Mahoney PC

  • Psychiatry Physician
  • Tucson, AZ
  • NPI 1265611743
  NPD (past) Authorized official
• Peace Club Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cocoa Beach, FL
  • NPI 1891206793
  NPD (past)
• Lafrontera Center Inc

  • Methadone Clinic
  • Tucson, AZ
  • NPI 1548361470
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1104990217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011319",
            "telephone_number": "321-259-1662",
            "fax_number": "321-259-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011319",
            "telephone_number": "321-259-1662",
            "fax_number": "321-259-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "BETHANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "3436",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "AZ",
            "license": "3436",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS12407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vedatta Maharaj, MD
• Maheem Enterprise LLC
• Maheem Enterprise LLC
• Ashish Mahindra, M.D.
• Jennifer Stewart Mahl, APRN
• Hallie Maier
• Mailis Soler, DMD, Ms, PLLC
• Diane Hermanie Mainwold, D.O.
• Anjali Majan
• Lina Majdalany

• Psychiatry Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.