Individual provider Active NPI

Myron Wade Bethel, MD

  • Obstetrics & Gynecology Physician
  • Reno, NV
National Provider Identifier
1255313250
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
12587 Issued in NV
Practice address
645 N Arlington Ave Ste 400
Reno, NV 89503-4451
Phone
(775) 329-6241
Fax
(775) 329-4921
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 12587 NV Primary

Addresses

Primary practice location

645 N Arlington Ave Ste 400
Reno, NV 89503-4451

Mailing address

645 N Arlington Ave Ste 400
Reno, NV 89503-4451
Phone (775) 329-6241

Other identifiers 1

IdentifierTypeStateIssuer
10942450OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080912000443 NV Practitioner - Obstetrics/Gynecology 8022184126 Reassigns benefits to 1 organization
I20211115000144 CO Practitioner - Obstetrics/Gynecology 8022184126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Southern California Keck School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB-GYN Associates LTDGroup PAC ID 4486633500, 21 clinicians

Practice addresses (Care Compare)

635 Innovation Dr
Suite 300
Reno, NV 89511-2215
Phone (775) 329-6241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12587NVMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Associates LTD Obstetrics & Gynecology CurrentSince Jul 1, 2022 Accepting new patients
Prowers County Hospital District CurrentSince Oct 19, 2021 Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Garcia, Ho, Klose and McGaw Medical Group LT Obstetrics & Gynecology Past Accepting new patients

Locations

403 Kendall Dr
Lamar, CO 81052
Phone (719) 336-6767

401 Kendall Dr
Lamar, CO 81052
Phone (719) 336-4343

635 Innovation Dr
Unit 300
Reno, NV 89511
Phone (775) 329-6241

645 N Arlington Ave
Ste 400
Reno, NV 89503
Phone (775) 329-6241

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1255313250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N ARLINGTON AVE STE 400",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034451",
            "telephone_number": "775-329-6241",
            "fax_number": "775-329-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 N ARLINGTON AVE STE 400",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034451",
            "telephone_number": "775-329-6241",
            "fax_number": "775-329-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEL",
        "first_name": "MYRON",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "12587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10942450",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.