Individual provider Active NPI

Betty Bencosme, PAT

  • Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1366844995
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAT9108277 Issued in FL
Practice address
3276 Greenwald Way N
Kissimmee, FL 34741-0728
Phone
(407) 944-0999
Fax
(407) 935-0691
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAT9108277 FL Primary

Addresses

Primary practice location

3276 Greenwald Way N
Kissimmee, FL 34741-0728

Mailing address

3276 Greenwald Way N
Kissimmee, FL 34741-0728
Phone (407) 944-0999

Other identifiers 1

IdentifierTypeStateIssuer
PAT9108277OtherFLFLORIDA LICENSE NUMBER

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20141016002366 FL Practitioner - Physician Assistant 3072734045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharon a. Stokes MD PAGroup PAC ID 7315955184, 3 clinicians

Practice addresses (Care Compare)

3276 Greenwald Way N
Kissimmee, FL 34741-0728
Phone 40794409991310

7798 Winter Garden Vineland Rd
Suite 100
Windermere, FL 34786-5932
Phone (407) 876-0994

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
89.39 of 100Reported as individual
Quality
80.72
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1366844995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3276 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-944-0999",
            "fax_number": "407-935-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3276 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-944-0999",
            "fax_number": "407-935-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENCOSME",
        "first_name": "BETTY",
        "credential": "PAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9108277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "PAT9108277",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.