Individual provider Active NPI

Bethany Michelle Carvajal, MD

  • Pediatrics Physician
  • Denver, CO
National Provider Identifier
1144545997
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
52395 Issued in CO
Practice address
301 W 6TH Ave
Denver, CO 80204-5182
Phone
(303) 602-8340
NPI assigned
Apr 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 52395 CO Primary

Addresses

Primary practice location

301 W 6TH Ave
Denver, CO 80204-5182

Mailing address

7115 Welford PL
Castle Pines, CO 80108-3468
Phone (720) 771-9177

Other identifiers 1

IdentifierTypeStateIssuer
47185074MedicaidCO

Other names 1

  • Bethany Michelle Griego Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180822002532 NM Practitioner - Pediatric Medicine 5597014654 Reassigns benefits to 1 organization
I20210824001290 CO Practitioner - Pediatric Medicine 5597014654 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52395COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Pediatrics CurrentSince Aug 20, 2018 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 20, 2018 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 1, 2021 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 1, 2021 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

301 W 6th Ave
Denver, CO 80204
Phone (303) 602-8070

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

454 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 303-5000

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

Interoperability endpoints

  • Direct secure messaging: bcarvajal256980@direct.dhha.org

Organizations & group practices 5

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1144545997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 WELFORD PL",
            "city": "CASTLE PINES",
            "state": "CO",
            "postal_code": "801083468",
            "telephone_number": "720-771-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W 6TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802045182",
            "telephone_number": "303-602-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVAJAL",
        "first_name": "BETHANY",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "52395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47185074",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "GRIEGO",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.