NPIMap

Individual provider Active NPI

Bethany Renee Canver, MD

  • Internal Medicine Physician
  • Pennsville, NJ
National Provider Identifier
1255820841
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA11541400 Issued in NJ
Practice address
390 N Broadway BLDG Ste 100
Pennsville, NJ 08070-1253
Phone
(856) 678-6411
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA11541400 NJ Primary

Addresses

Primary practice location

390 N Broadway BLDG Ste 100
Pennsville, NJ 08070-1253

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other identifiers 6

IdentifierTypeStateIssuer
008056168MedicaidCT
008039745MedicaidCT
008068298MedicaidCT
008056033MedicaidCT
008103365MedicaidCT
004217099MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20221123001239 NJ Practitioner - Internal Medicine 0648525113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Family Medicine PCGroup PAC ID 4284530197, 117 clinicians

Practice addresses (Care Compare)

390 N Broadway
Suite 100
Pennsville, NJ 08070-1253
Phone (856) 678-6411

Hospital & facility affiliations

  • Bayada at Inspira, Home Health and Hospice Home health agency, Millville, NJ, CCN 317089
  • Holy Redeemer Home Care NJ South Home health agency, Runnemede, NJ, CCN 317025
  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014
  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11541400NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Medical Centers, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bcanver37583@direct.cooperhealth.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1255820841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N BROADWAY BLDG STE 100",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701253",
            "telephone_number": "856-678-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANVER",
        "first_name": "BETHANY",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11541400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008056168",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008039745",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008068298",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008056033",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008103365",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004217099",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsville, NJ

Sources for this page

Verify at the official NPI Registry.