Organization Active NPI

Bethel Medical Associates LLC

  • Internal Medicine Physician
  • New City, NY
National Provider Identifier
1316219256
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
225651 Issued in NY
Legal business name
BETHEL MEDICAL ASSOCIATES LLC
Practice address
10 Esquire Rd
Suite 9
New City, NY 10956-3336
Phone
(845) 499-2460
NPI assigned
Feb 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Authorized official

Name
Dr. Stanley John, M.DNPI 1346272333
Title
Owner
Phone
(845) 499-2460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 225651 NY Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 259643 NY

Addresses

Primary practice location

10 Esquire Rd
Suite 9
New City, NY 10956-3336

Mailing address

10 Esquire Rd Ste 9
New City, NY 10956-3336
Phone (845) 499-2460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130114000234 NY Part B Supplier - Clinic/Group Practice 4688827116 Receives reassigned benefits from 2 practitioners
Practice locations: New City, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2052681Bethel Medical Associates, LLC10 Esquire Road, Suite 9, New City, NY 10956Certificate of waiverJan 15, 2027

National Provider Directory

National Provider Directory

Locations

10 Esquire Rd
Ste 9
New City, NY 10956
Phone (201) 254-4766

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1316219256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ESQUIRE RD STE 9",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109563336",
            "telephone_number": "845-499-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ESQUIRE RD",
            "address_2": "SUITE 9",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109563336",
            "telephone_number": "845-499-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-499-2460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225651",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "259643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.