Marie-Claude Bettencourt, MD
Individual provider Active NPI Urology Physician · Springfield, VT
NPI 1477583250 · NPPES record last updated May 15, 2014
Key facts
- NPI
- 1477583250
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 042-0010862 (VT)
- Practice address
- 29 Ridgewood Rd
Springfield, VT 05156-3060 - Phone
- (802) 886-3556
- Fax
- (802) 886-2535
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT, NH
- 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 |
|---|---|---|---|---|
| I20050201000240 | VT | Practitioner - Urology | 7618927203 | Reassigns benefits to 2 organizations |
| I20060802000145 | NH | Practitioner - Urology | 7618927203 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101252507 | VA | MD | Urology Physician |
| 042-0010862 | VT | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Hitchcock Memorial Hospital | Current |
Accepting new patients | |
| Mary Hitchcock Memorial Hospital | Current |
Accepting new patients | |
| Dartmouth-Hitchcock Clinic | Current |
Accepting new patients | |
| Springfield Medical Care Systems Inc | Current |
Accepting new patients | |
| Springfield Medical Care Systems Inc. | Current |
Accepting new patients | |
| Springfield Hospital Inc | Current |
Accepting new patients |
Locations
1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922
1 Hospital Ct
Bellows Falls, VT 05101
Phone (802) 463-1292
25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593
364 River St
Springfield, VT 05156
Phone (802) 886-1507
29 Ridgewood Rd
Springfield, VT 05156
Phone (802) 885-5733
289 County Rd
Windsor, VT 05089
Phone (802) 674-7220
Interoperability endpoints
- https://api.platform.athenahealth.com/21546/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 042-0010862 | VT | Yes |
| Urology Physician | 208800000X | 0101252507 | VA |
Addresses
Primary practice location
29 Ridgewood Rd
Springfield, VT 05156-3060
Mailing address
PO Box 1612
Brattleboro, VT 05302-1612
Phone (802) 886-3556
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477583250 | Medicaid | VA | |
| 1011134 | Medicaid | VT | |
| 3070634 | Medicaid | NH |
Other providers in Springfield, VT
- Jeffrey Michael Bell
- Kathleen M Bell
- Shammi L Belliveau
- Amy Bernier
- Denise L. Best
- Joseph Thomas Bielamowicz
- Johanah Boucher
- Lindsey Boulter
- Erin F. Boxer
- Yee-Wah Brabant
All providers in Springfield, VT · Urology Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2014. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.