Kenneth R Betts, MD
Individual provider Active NPI Family Medicine Physician · Edgerton, WI
NPI 1457435950 · NPPES record last updated Nov 3, 2020
Key facts
- NPI
- 1457435950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 39870-20 (WI)
- Practice address
- 11051 N Sherman Rd
Edgerton, WI 53534-9002 - Phone
- (608) 884-3354
- Fax
- (608) 884-5022
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dean Health Systems Inc
Practice addresses (Care Compare)
11051 N Sherman Rd
Edgerton, WI 53534-9002
Phone (608) 884-3354
Hospital & facility affiliations
- SSM Health St Mary'S Hospital - Madison
- SSM Health St Mary'S Hospital - Janesville
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100127000531 | WI | Practitioner - General Practice | 1557259363 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39870-20 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc. | Current |
Accepting new patients | |
| Dean Health Systems, Inc | Family Medicine | Current |
Accepting new patients |
Locations
1700 Tuttle St
Baraboo, WI 53913
Phone (608) 355-3800
11051 N Sherman Rd
Edgerton, WI 53534
Phone (608) 884-3354
11101 N Sherman Rd
Edgerton, WI 53534
Phone (608) 884-1695
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410
Interoperability endpoints
- kbetts261608@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 39870-20 | WI | Yes |
Addresses
Primary practice location
11051 N Sherman Rd
Edgerton, WI 53534-9002
Mailing address
11051 N Sherman Rd
Edgerton, WI 53534-9002
Phone (608) 884-3354
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457435950 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kbetts261608@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Other providers in Edgerton, WI
- Andrea Christine Alviar
- Bethany Ann Appel
- Leonor Bartes
- Rebecca Beese
- Betts Family Medical Clinic, LTD
- Bhanu P Sankineni LLC
- Carmen Jean Bills
- Rajvinder Singh Bindra
- Sandy Biviano
- Sandra Lea Bjornstad
All providers in Edgerton, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.