NPIMap

Individual provider Active NPI

Joseph Bettendorf, M.D.

  • Emergency Medicine Physician
  • Duluth, MN
National Provider Identifier
1225327620
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
60993 Issued in MN
Practice address
407 E 3Rd St
Essentia Health St. Mary's Medical Center
Duluth, MN 55805-1950
Phone
(218) 786-4000
Fax
(585) 473-3516
NPI assigned
Apr 6, 2011
Last updated
Feb 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 60993 MN Primary
Emergency Medicine Physician 207P00000X 66319-20 WI

Addresses

Primary practice location

407 E 3Rd St
Essentia Health St. Mary's Medical Center
Duluth, MN 55805-1950

Mailing address

400 E 3Rd St
Essentia Health Duluth Clinic McL2Cred
Duluth, MN 55805-1951
Phone (218) 786-8319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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
I20160818002065 MN Practitioner - Emergency Medicine 4981821113 Reassigns benefits to 10 organizations
I20170221002082 WI Practitioner - Emergency Medicine 4981821113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essentia Health Virginia LLCGroup PAC ID 7810149002, 64 clinicians

Practice addresses (Care Compare)

901 9TH St N
Virginia, MN 55792-2325
Phone (218) 741-3340

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60993MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Hospital of Superior CurrentSince Mar 20, 2017 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Aug 22, 2016 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
Essentia Health Moose Lake CurrentSince May 17, 2021 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Aug 22, 2016 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
Essentia Health Moose Lake CurrentSince May 17, 2021 Accepting new patients
Northern Pines Medical Center CurrentSince Aug 22, 2016 Accepting new patients
Pine Medical Center CurrentSince Aug 22, 2016 Accepting new patients
St Marys Medical Center CurrentSince Aug 22, 2016 Accepting new patients
Deer River Healthcare Center, Inc CurrentSince Aug 22, 2016 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Mar 20, 2017 Accepting new patients
Northern Pines Medical Center CurrentSince Aug 22, 2016 Accepting new patients
Pine Medical Center CurrentSince Aug 22, 2016 Accepting new patients
St. Mary's Medical Center CurrentSince Aug 22, 2016 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Duluth Graduate Medical Education Council Inc Past Accepting new patients

Locations

5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 5

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1225327620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "address_2": "ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4000",
            "fax_number": "585-473-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTENDORF",
        "first_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "60993",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "66319-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.