Individual provider Active NPI

Betsy L Kendis, M.D.

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1326049081
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35070944 Issued in OH
Practice address
3951 Convenience Cir NW Ste 100
Canton, OH 44718-2686
Phone
(330) 499-9944
Fax
(330) 499-3056
NPI assigned
Aug 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 35070944 OH
Pediatrics Physician 208000000X 35070944 OH
Internal Medicine Physician 207R00000X 35070944 OH Primary

Addresses

Primary practice location

3951 Convenience Cir NW Ste 100
Canton, OH 44718-2686

Mailing address

3951 Convenience Cir NW Ste 100
Canton, OH 44718-2686
Phone (330) 499-9944

Other identifiers 1

IdentifierTypeStateIssuer
2017749MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100505001030 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2365570793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Cincinnati College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Physician Associates, Inc.Group PAC ID 4082673678, 2 clinicians

Practice addresses (Care Compare)

3951 Convenience Cir NW
Suite 100
Canton, OH 44718-2686
Phone (330) 499-9944

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Physician Associates, Inc. Internal Medicine CurrentSince Jul 21, 1997 Accepting new patients

Locations

3951 Convenience Cir NW
Canton, OH 44718
Phone (330) 493-9904

4575 Stephens Cir NW
Canton, OH 44718
Phone (330) 499-9944

3951 Convenience Cir NW
Ste 100
Canton, OH 44718
Phone (330) 499-9944

Organizations & group practices 1

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 2

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1326049081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3951 CONVENIENCE CIR NW STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182686",
            "telephone_number": "330-499-9944",
            "fax_number": "330-499-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3951 CONVENIENCE CIR NW STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182686",
            "telephone_number": "330-499-9944",
            "fax_number": "330-499-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDIS",
        "first_name": "BETSY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2024-06-24",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "OH",
            "license": "35070944",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35070944",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35070944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017749",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.