Individual provider Active NPI

Elizabeth Obber Bettencourt, MD

  • Obstetrics & Gynecology Physician
  • Melrose, MA
National Provider Identifier
1366436974
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
207705 Issued in MA
Practice address
50 Rowe St
Suite 400
Melrose, MA 02176-3201
Phone
(781) 665-6606
Fax
(781) 665-1277
NPI assigned
Sep 9, 2005
Last updated
Jun 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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 207705 MA Primary

Addresses

Primary practice location

50 Rowe St
Suite 400
Melrose, MA 02176-3201

Mailing address

50 Rowe Street
Suite 400
Melrose, MA 02176
Phone (781) 665-6606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080609000765 MA Practitioner - Obstetrics/Gynecology 7517037112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

425 Revere St
Revere, MA 02151-4543
Phone (781) 665-6606

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 979-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Obstetrics & Gynecology CurrentSince Aug 1, 2018 Accepting new patients
Melrosewakefield Healthcare, Inc. Past Accepting new patients

Locations

50 Rowe St
Melrose, MA 02176
Phone (781) 620-4944

50 Rowe St
Ste 400
Melrose, MA 02176
Phone (781) 665-6605

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Interoperability endpoints

  • Direct secure messaging: ebettencourt23925@tuftsmedicine.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1366436974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROWE STREET",
            "address_2": "SUITE 400",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "02176",
            "telephone_number": "781-665-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROWE ST",
            "address_2": "SUITE 400",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763201",
            "telephone_number": "781-665-6606",
            "fax_number": "781-665-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTENCOURT",
        "first_name": "ELIZABETH",
        "middle_name": "OBBER",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "207705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.