NPIMap

Individual provider Active NPI

Bethwel Raore, MD

  • Neurological Surgery Physician
  • Suwanee, GA
National Provider Identifier
1215114475
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
076431 Issued in GA
Practice address
454 Satellite Blvd NW Ste 100
Suwanee, GA 30024-7191
Phone
(678) 250-0880
Fax
(678) 963-5307
NPI assigned
Jan 29, 2008
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35098259 OH
Neurological Surgery Physician 207T00000X 076431 GA Primary

Addresses

Primary practice location

454 Satellite Blvd NW Ste 100
Suwanee, GA 30024-7191

Mailing address

454 Satellite Blvd NW Ste 100
Suwanee, GA 30024-7191
Phone (678) 250-0880

Other identifiers 1

IdentifierTypeStateIssuer
0063115MedicaidOH

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160810000628 GA Practitioner - Neurosurgery 8921263872 Reassigns benefits to 3 organizations
I20210811002810 CO Practitioner - Neurosurgery 8921263872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Apex Spine and Neurosurgery LLCGroup PAC ID 1355754631, 9 clinicians
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

1600 N Grand Ave
Pueblo, CO 81003-2757

3680 Pleasant Hill Rd
Duluth, GA 30096-3268
Phone (770) 813-5575

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

426 Exchange Blvd
Suite 500
Bethlehem, GA 30620-1797
Phone 6782500880302

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

875 Flat Shoals Rd SE
Conyers, GA 30094-6640
Phone (770) 785-7669

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion56
Laminectomy or laminotomy (partial removal of spine bones)13
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35098259OHMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Spine and Neurosurgery LLC Single Specialty Current Accepting new patients
Poudre Valley Medical Group, LLC Specialist CurrentSince Jun 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Single Specialty CurrentSince Jun 1, 2025 Accepting new patients
Gwinnett Physician Group, LLC Single Specialty CurrentSince Sep 1, 2016 Accepting new patients
Apex Spine and Neurosurgery LLC Single Specialty CurrentSince Dec 28, 2020 Accepting new patients
Surgical Services of Georgia LLC PastSince Oct 5, 2023 Accepting new patients
Ohio Neurosurgical Institute Inc Single Specialty Past Accepting new patients
Gwinnett Medical Group, Inc Single Specialty Past Accepting new patients

Locations

1600 N Grand Ave
Ste 508
Pueblo, CO 81003
Phone (719) 595-7040

426 Exchange Blvd
Ste 500
Bethlehem, GA 30620
Phone (470) 437-2562

6600 Sugarloaf Pkwy
Ste 400230
Duluth, GA 30097
Phone (260) 415-2219

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

631 Professional Dr
Ste 360
Lawrenceville, GA 30046
Phone (678) 312-3290

454 Satellite Blvd NW
Ste 100
Suwanee, GA 30024
Phone (678) 250-0880

Interoperability endpoints

  • Direct secure messaging: bethwel.raore.1@29469.direct.athenahealth.com
  • Direct secure messaging: bethwel.raore.p44@direct.newportmed.nextgenshare.com
  • Direct secure messaging: bethwel.raore.p46@direct.newportmed.nextgenshare.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1215114475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 SATELLITE BLVD NW STE 100",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247191",
            "telephone_number": "678-250-0880",
            "fax_number": "678-963-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 SATELLITE BLVD NW STE 100",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247191",
            "telephone_number": "678-250-0880",
            "fax_number": "678-963-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAORE",
        "first_name": "BETHWEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35098259",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "076431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.