Individual provider Active NPI

Mary Catherine Bentler, P.A.

  • Physician Assistant
  • West Burlington, IA
National Provider Identifier
1205074267
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001970 Issued in IA
Practice address
1225 S Gear Ave
Suite 153
West Burlington, IA 52655-1691
Phone
(319) 754-4400
Fax
(319) 754-4412
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001970 IA Primary

Addresses

Primary practice location

1225 S Gear Ave
Suite 153
West Burlington, IA 52655-1691

Mailing address

1225 S Gear Ave
Suite 153
West Burlington, IA 52655-1691
Phone (319) 754-4400

Other identifiers 2

IdentifierTypeStateIssuer
1205074267OtherIAWELLMARK BLUE CROSS/BLUE SHIELD
1275533713MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090316000581 IA Practitioner - Physician Assistant 1658438825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 S Gear Ave
West Burlignton, IA 52655-1679
Phone (319) 768-1000

5409 Ave O
Fort Madison, IA 52627-9602

5445 Ave O
Fort Madison, IA 52627-9611
Phone (319) 376-2134

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.06 of 100Reported as group
Quality
64.36
Promoting interoperability
81
Improvement activities
40
Cost
75.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001970IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients

Locations

5409 Avenue O
Fort Madison, IA 52627
Phone (319) 372-6530

5445 Avenue O
Fort Madison, IA 52627
Phone (319) 372-6530

5409 Avenue O
Ste 1
Fort Madison, IA 52627
Phone (319) 376-2134

5409 Avenue O
Ste 122
Fort Madison, IA 52627
Phone (319) 376-2400

1225 S Gear Ave
Ste 153
West Burlington, IA 52655

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1205074267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S GEAR AVE",
            "address_2": "SUITE 153",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551691",
            "telephone_number": "319-754-4400",
            "fax_number": "319-754-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GEAR AVE",
            "address_2": "SUITE 153",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551691",
            "telephone_number": "319-754-4400",
            "fax_number": "319-754-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLER",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS/BLUE SHIELD",
            "identifier": "1205074267",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275533713",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.