NPIMap

Organization Active NPI

Bethany Primary Care

  • Internal Medicine Physician
  • Bethany Beach, DE
National Provider Identifier
1508872052
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0008098 Issued in DE
Legal business name
BETHANY PRIMARY CARE
Practice address
33188 Coastal Hwy
Suite 4
Bethany Beach, DE 19930-3779
Phone
(302) 537-1100
Fax
(302) 537-0921
NPI assigned
Aug 1, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Rajshekar Narasimaiah, M.D.
Title
Owner
Phone
(302) 537-1100

Practitioners 8

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
08D0953220Bethany Primary Care33188 Coastal Highway, Bethany Beach, DE 19930Certificate of waiverFeb 21, 2028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000159 DE Part B Supplier - Clinic/Group Practice 6901797927 Receives reassigned benefits from 4 practitioners
Practice locations: Bethany Beach, DE

National Provider Directory

National Provider Directory

Locations

33188 Coastal Hwy
Unit 4
Bethany Beach, DE 19930
Phone (302) 537-1100

33188 Coastal Hwy
Bethany Beach, DE 19930
Phone (302) 537-1100

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X C1-0008098 DE Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X C1-0009184 DE
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X LG-0000463 DE
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X LG-0000712 DE

Addresses

NPPES NPI Registry

Primary practice location

33188 Coastal Hwy
Suite 4
Bethany Beach, DE 19930-3779

Mailing address

33188 Coastal Hwy
Suite 4
Bethany Beach, DE 19930-3779
Phone (302) 537-1100

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1000014404MedicaidDE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2014.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1508872052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33188 COASTAL HWY",
            "address_2": "SUITE 4",
            "city": "BETHANY BEACH",
            "state": "DE",
            "postal_code": "199303779",
            "telephone_number": "302-537-1100",
            "fax_number": "302-537-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33188 COASTAL HWY",
            "address_2": "SUITE 4",
            "city": "BETHANY BEACH",
            "state": "DE",
            "postal_code": "199303779",
            "telephone_number": "302-537-1100",
            "fax_number": "302-537-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "NARASIMAIAH",
        "authorized_official_first_name": "RAJSHEKAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-537-1100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0008098",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0009184",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0000463",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0000712",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000014404",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany Beach, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.