Benjamin Bryce Betteridge, MD, CAQ SPORTS MEDIC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

43643 Issued in WA

Practice address

3733 So Thompson Ave
Tacoma, WA 98418

Phone

(253) 472-4473

Fax

(253) 474-3056

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Specialty

Sports MedicineAlso: Emergency Medicine

Education

University of Kansas School of Med (KC/Wich/Sal), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Merit-based Incentive Payment System (MIPS)

Final score

90.26 of 100Reported as apm

Quality

89.39

Promoting interoperability

85.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbetteridge68056@ghc.direct-ci.net

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.

• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment Care Compare group NPD
• Betteridge & McNaughton PS Inc

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1457552770
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Sports Medicine Specialists, LLC

  • Sports Medicine (Family Medicine) Physician
  • Bountiful, UT
  • NPI 1942259197
  NPD (past) Authorized official
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons, Inc., P.S.

  • Surgery Physician
  • Bellevue, WA
  • NPI 1578801718
  NPD
• Proliance Surgeons, Inc., P.S.

  • Otolaryngology Physician
  • Burien, WA
  • NPI 1114108784
  NPD (past)
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  NPD (past)
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD (past)

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

• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1225007388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 SOUNDVIEW DR. WEST",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "98466",
            "telephone_number": "253-283-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 SO THOMPSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98418",
            "telephone_number": "253-472-4473",
            "fax_number": "253-474-3056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9505 S Steele St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984441858",
            "country_code": "US",
            "telephone_number": "253-597-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETTERIDGE",
        "first_name": "BENJAMIN",
        "middle_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "MD, CAQ SPORTS MEDIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "UT",
            "license": "2948311205",
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD00043643",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "UT",
            "license": "294831-1205",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD00043643",
            "primary": false
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "WA",
            "license": "43643",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "WA",
            "license": "43643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942854058788-D6149",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9505 S Steele St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984441858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly Gill Beth, LCSW, LICSW
• Jackline Cherop Bett
• Kaitlin Alissa Bettencourt, M.D
• Better Outlook Psychiatry & Wellness PLLC
• Betteridge & McNaughton PS Inc
• Bryce Cahoon Betteridge
• Loren B Betteridge, MD
• Bonnie Betts, OTR/L
• Shantel Beua, CMA
• Christine Melody Beuning, PHARM.D.

• Sports Medicine (Emergency Medicine) Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Sports Medicine (Emergency Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.