Jordyn Deborah Bethea, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0007175 Issued in MD

Practice address

3001 S Hanover St Ste 216a
Baltimore, MD 21225-1233

Phone

(410) 350-2106

NPI assigned

Jun 25, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Medstar Heart Institute LLCGroup PAC ID 5698932960, 308 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Union Memorial Hospital Hospital, Baltimore, MD, CCN 210024

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187
  Medicare reassignment Care Compare group
• Medstar Heart Institute LLC

  • Surgery Physician
  • Washington, DC
  • NPI 1528345378

  MD

  Medicare reassignment Care Compare group
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Union Memorial Hospital

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1487741427
  Care Compare affiliation

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1265872105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 LIGHT ST UNIT 4201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212021347",
            "telephone_number": "732-310-8214",
            "fax_number": "561-498-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S HANOVER ST STE 216A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251233",
            "telephone_number": "410-350-2106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4205 W Atlantic Ave",
            "address_2": "Bldg B Suite 201",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334453901",
            "country_code": "US",
            "telephone_number": "561-638-9140",
            "fax_number": "561-498-0320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "JORDYN",
        "middle_name": "DEBORAH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0007175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018266800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth K. Vincent Counseling and Consulting
• Beth Rapha Behavioral Health System, LLC
• Bethan McGarry LLC
• Bethany Gallagher LLC
• Diamond Bethea
• Julianne Bethea, C.R.N.P.
• Yolanda Roshel Bethea, CRNP
• Kelli Bethel
• Brooke Nicole Betlaf
• Michelle Lynn Betner, HAD & SLP

• Medical Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.

Verify at the official NPI Registry.