NPIMap

Organization Active NPI

Bruce a Bethancourt MD PC

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1144433152
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12752 Issued in AZ
Legal business name
BRUCE A BETHANCOURT MD PC
Practice address
4400 N 32ND St Ste 140
Phoenix, AZ 85018-3964
Phone
(602) 254-1429
Fax
(602) 778-3513
NPI assigned
May 7, 2007
Last updated
Nov 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Bruce A Bethancourt, MDNPI 1548252513
Title
Owner Physician
Phone
(602) 254-1429

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 12752 AZ Primary

Addresses

Primary practice location

4400 N 32ND St Ste 140
Phoenix, AZ 85018-3964

Mailing address

5922 E Cheney Dr
Paradise Valley, AZ 85253-3574
Phone (602) 778-6789

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1144433152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5922 E CHENEY DR",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852533574",
            "telephone_number": "602-778-6789",
            "fax_number": "602-778-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N 32ND ST STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183964",
            "telephone_number": "602-254-1429",
            "fax_number": "602-778-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE A BETHANCOURT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "BETHANCOURT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "602-254-1429",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "12752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.