Individual provider Active NPI

Bethany Ellen Ziss, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Pittsburgh, PA
National Provider Identifier
1184829533
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
MD454191 Issued in PA
Practice address
4815 Liberty Ave Ste 154
Pittsburgh, PA 15224-2156
Phone
(412) 578-4003
Fax
(412) 578-4011
NPI assigned
Jun 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD454191 PA
Developmental - Behavioral Pediatrics Physician 2080P0006X 33473 SC
Developmental - Behavioral Pediatrics Physician 2080P0006X MD454191 PA Primary

Addresses

Primary practice location

4815 Liberty Ave Ste 154
Pittsburgh, PA 15224-2156

Mailing address

1405 Shady Ave
Pittsburgh, PA 15217-1350
Phone (412) 420-2561

Other identifiers 2

IdentifierTypeStateIssuer
1030053080001MedicaidPA
PENDINGMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, PA2 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
I20141030000217 SC Practitioner - Pediatric Medicine 4688895931 Reassigns benefits to 2 organizations
I20150427001319 PA Practitioner - Pediatric Medicine 4688895931 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33473SCMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 15, 2014 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Pediatrics CurrentSince Sep 15, 2014 Accepting new patients
Greenville Health System CurrentSince Sep 15, 2014 Accepting new patients
Allegheny Clinic Pediatrics Pediatrics Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: bziss287881@direct.ahn.org

Organizations & group practices 7

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": "1182038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1184829533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SHADY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152171350",
            "telephone_number": "412-420-2561",
            "fax_number": "412-420-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 154",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-578-4003",
            "fax_number": "412-578-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISS",
        "first_name": "BETHANY",
        "middle_name": "ELLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-17",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD454191",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "SC",
            "license": "33473",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "PA",
            "license": "MD454191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030053080001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.