Active NPI
Vivian K Bethala, MD
- Specialist
- Emerson, NJ
National Provider Identifier
1235191800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 25MA03714400
- Practice address
- 466 Old Hook Rd
Suite 9
Emerson, NJ 07630-1396 - Phone
- (201) 261-1005
- Fax
- (201) 261-4208
- NPI assigned
- Apr 6, 2006
- Last updated
- Aug 10, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25MA03714400 | NJ | Primary |
Addresses
Primary practice location
466 Old Hook Rd
Suite 9
Emerson, NJ 07630-1396
Mailing address
466 Old Hook Rd
Suite 9
Emerson, NJ 07630-1396
Phone (201) 261-1005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4906403 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11 -26 Saddle River Rd
Fair Lawn, NJ 07410-5634
Phone (201) 796-9200
466 Old Hook Rd
Suite 9
Emerson, NJ 07630-1368
Phone (201) 261-1005
Hospital & facility affiliations
- Valley Home Care Inc.
- Valley Hospital
- Hackensack Meridian Health Pascack Valley Medical
- Holy Name Medical Center
- Englewood Hospital and Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.42 of 100
- Quality
- 91.18
- Improvement activities
- 40
- Cost
- 77.19
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.98 of 100
- Quality
- 95
- Improvement activities
- 40
- Cost
- 73.25
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 228 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 335 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03714400 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vivian K. Bethala, MD PA | Specialist | Current | Accepting new patients |
| Medical Multispecialty Association PA | Current | Accepting new patients |
Locations
466 Old Hook Rd
Ste 9
Emerson, NJ 07630
Phone (201) 261-1005
11-26 Saddle River Rd
Fair Lawn, NJ 07410
Phone (201) 509-8205
Interoperability endpoints
- vbethala189427@ahs.direct-ci.com
- vivian.bethala@glacecentral.com
Organizations & group practices 2
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.
-
- Specialist
- Emerson, NJ
- NPI 1568412799
-
- Internal Medicine Physician
- Fair Lawn, NJ
- NPI 1891905873
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Englewood, NJ
- NPI 1083612881
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Teaneck, NJ
- NPI 1043389349
Hospital
-
- General Acute Care Hospital
- Teaneck, NJ
- NPI 1104859131
-
dba HackensackUMC at Pascack Valley
- General Acute Care Hospital
- Westwood, NJ
- NPI 1205176062
-
- General Acute Care Hospital
- Paramus, NJ
- NPI 1013912633
-
- Home Health Agency
- Paramus, NJ
- NPI 1174588925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1235191800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "466 OLD HOOK RD",
"address_2": "SUITE 9",
"city": "EMERSON",
"state": "NJ",
"postal_code": "076301396",
"telephone_number": "201-261-1005",
"fax_number": "201-261-4208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "466 OLD HOOK RD",
"address_2": "SUITE 9",
"city": "EMERSON",
"state": "NJ",
"postal_code": "076301396",
"telephone_number": "201-261-1005",
"fax_number": "201-261-4208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETHALA",
"first_name": "VIVIAN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-06",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25MA03714400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4906403",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Emerson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.