NPIMap

Individual provider Active NPI

Bethany M. Lucas, PA

  • Surgical Physician Assistant
  • Midland, TX
National Provider Identifier
1225283963
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA05955 Issued in TX
Practice address
5615 Deauville Ste 220
Midland, TX 79706-2707
Phone
(432) 221-4755
Fax
(432) 686-0664
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05955 TX
Physician Assistant 363A00000X 12533 MN
Medical Physician Assistant 363AM0700X PA05955 TX
Surgical Physician Assistant 363AS0400X PA05955 TX Primary

Addresses

Primary practice location

5615 Deauville Ste 220
Midland, TX 79706-2707

Mailing address

5615 Deauville Ste 220
Midland, TX 79706-2707
Phone (325) 226-3503

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090212000345 TX Practitioner - Physician Assistant 4587729272 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midland Texas Orthopedic Group IncGroup PAC ID 1850527557, 16 clinicians

Practice addresses (Care Compare)

5615 Deauville
Suite 220
Midland, TX 79706-2707
Phone (432) 686-0321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12533MNMDPhysician Assistant
PA05955TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Angelo Emergency Physicians Past Accepting new patients
Oasis of West TX Emergency Physician Assistant Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Tom Green Emergency Medicine Associates PA Medical Past Accepting new patients
Jumano Emergency Physicians Physician Assistant Past Accepting new patients
Texas Em-1 Medical Services, PA Physician Assistant Past Accepting new patients
West Texas Orthopedics LLP Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock PastSince Apr 30, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bethany.wood.1@3522.direct.athenahealth.com

Organizations & group practices 12

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 1

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1225283963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 DEAUVILLE STE 220",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062707",
            "telephone_number": "325-226-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 DEAUVILLE STE 220",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062707",
            "telephone_number": "432-221-4755",
            "fax_number": "432-686-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "BETHANY",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05955",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12533",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05955",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA05955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.