Joseph D Bettencourt MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A67264 Issued in CA

Legal business name

JOSEPH D BETTENCOURT MD INC

Practice address

2120 Golden Hill Rd
Suite 202
Paso Robles, CA 93446

Phone

(805) 434-2240

Fax

(805) 434-0102

NPI assigned

Aug 24, 2011

Organization subpart

No

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

Authorized official

Name

Joseph D Bettencourt, MDNPI 1396796215

Title

President

Phone

(805) 434-2240

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIFCBD

Practitioners 1

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

• Joseph D Bettencourt, MD

  • Family Medicine Physician
  • Paso Robles, CA
  • NPI 1396796215
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1386924249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 GOLDEN HILL RD",
            "address_2": "SUITE 202",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "93446",
            "telephone_number": "805-434-2240",
            "fax_number": "805-434-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 GOLDEN HILL RD",
            "address_2": "SUITE 202",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "93446",
            "telephone_number": "805-434-2240",
            "fax_number": "805-434-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH D BETTENCOURT MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-24",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "BETTENCOURT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-434-2240",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A67264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVED CERTIFICATE NUMBER",
            "identifier": "05D0973925",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY OF PASO ROBLES BUSINESS LICENSE",
            "identifier": "10610",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE-DEPT OF CORPORATIONS NUMBER",
            "identifier": "C3356037",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA STATE REGISTRATION NUMBER",
            "identifier": "CLR326953",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John L. Eller D.D.S
• Constance Linnea Johnson
• Jacqueline Marie Jolicoeur, OTR/L
• Kellie Jones
• Rhys Jones, M.D.
• Abigail Victoria Joy, PHARMD
• Meegan Lee Justice
• Jeffery Scott Kahler, D.D.S.
• Meaghan Lynne Kane, ACSW
• Daniel J Kanefield, PHARM. D

• Family Medicine Physician in Paso Robles, CA
• Providers in Paso Robles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.