Active NPI
Andrea Betancourt, PA
- Physician Assistant
- Homestead, FL
National Provider Identifier
1144005208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9117781
- Practice address
- 975 Baptist Way
Homestead, FL 33033-7600 - Phone
- (786) 886-6255
- NPI assigned
- Aug 28, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9117781 | FL | Primary |
Addresses
Primary practice location
975 Baptist Way
Homestead, FL 33033-7600
Mailing address
13330 SW 103Rd Ter
Miami, FL 33186-2840
Phone (786) 886-6255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9117781 | FL | MD | Physician Assistant |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1144005208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13330 SW 103RD TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331862840",
"telephone_number": "786-886-6255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 BAPTIST WAY",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330337600",
"telephone_number": "786-886-6255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETANCOURT",
"first_name": "ANDREA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-28",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9117781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.