Betsy Cooduvalli, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS10726 Issued in FL

Practice address

500 N Washington Ave Ste 109
Titusville, FL 32796

Phone

(321) 768-1600

NPI assigned

Jun 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Betsy Leveritt Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

86.64 of 100Reported as group

Quality

73.28

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Aqua Dermatology of Florida, PA

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1538270335
  Medicare reassignment NPD
• Associates in Dermatology Inc

  • Specialist
  • Kissimmee, FL
  • NPI 1316960297
  Medicare reassignment NPD
• J Matthew Knight M D P a

  • Procedural Dermatology Physician
  • Orlando, FL
  • NPI 1386830263
  Medicare reassignment NPD
• Florida Dermatology Associates Inc

  • MOHS-Micrographic Surgery Physician
  • Palm Bay, FL
  • NPI 1073577136
  Medicare reassignment
• Naples Center for Dermatology & Riverchase Dermatology

  • Durable Medical Equipment & Medical Supplies
  • Cape Coral, FL
  • NPI 1538645775
  NPD
• Betsy Beers MD PA

  • Dermatopathology Physician
  • Gainesville, FL
  • NPI 1841311933

  Dermatology

  NPD (past)
• Melvin C. Lu, M.D., LLC

  • Dermatology Physician
  • Brooksville, FL
  • NPI 1679761563
  NPD (past)

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1437410230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690609",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328690609",
            "telephone_number": "407-846-7546",
            "fax_number": "321-206-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WASHINGTON AVE STE 109",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "32796",
            "telephone_number": "321-768-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2910 Brownwood Blvd",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "32163",
            "country_code": "US",
            "telephone_number": "352-674-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2910 Brownwood Blvd",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "32163",
            "country_code": "US",
            "telephone_number": "352-674-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Boston Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327014712",
            "country_code": "US",
            "telephone_number": "407-846-7546",
            "fax_number": "321-206-5419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COODUVALLI",
        "first_name": "BETSY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS10726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4583149",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14M7E",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSY",
            "last_name": "LEVERITT",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dermatology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.