Charles N. Bethmann, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

010207M14 Issued in MD

Practice address

115 Sallitt Dr
Suite E
Stevensville, MD 21666-2156

Phone

(410) 643-7800

Fax

(410) 643-7568

NPI assigned

Aug 2, 2005

Last updated

Jan 19, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Physician Assistant

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ydiprmc, LLCGroup PAC ID 3173897402, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ydiprmc LLC

  dba TidalHealth Urgent Care

  • Urgent Care Clinic/Center
  • Salisbury, MD
  • NPI 1447783899
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1487655338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BENFIELD BLVD",
            "address_2": "SUITE 200",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211083002",
            "telephone_number": "410-729-5100",
            "fax_number": "410-729-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SALLITT DR",
            "address_2": "SUITE E",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662156",
            "telephone_number": "410-643-7800",
            "fax_number": "410-643-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHMANN",
        "first_name": "CHARLES",
        "middle_name": "N.",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "010207M14",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayside Dental Associates, PA
• Bayside Physical Therapy & Sports Rehabilitation Limited Partnership
• Bayside Physical Therapy and Rehabilitation, Inc
• Bellwether Therapy LLC
• Amy Louise Gibbs Bennett, LCPC, NCC
• Crystal Renee Blanchard, MA. LCPC
• Blue Heron Coastal Counseling and Wellness LLC
• Amberly Boardley, RN
• Benjamin Boches
• Allison Bower, L.AC.

• Physician Assistant in Stevensville, MD
• Providers in Stevensville, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.