Active NPI
Jean Bettel Damas, PA
- Physician Assistant
- Chicopee, MA
National Provider Identifier
1548899131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 082-PA
- Practice address
- 77 Edbert St Apt C
Chicopee, MA 01020-2837 - Phone
- (413) 297-6682
- NPI assigned
- Apr 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 082-PA | PR | Primary |
Addresses
Primary practice location
77 Edbert St Apt C
Chicopee, MA 01020-2837
Mailing address
77 Edbert St Apt C
Chicopee, MA 01020-2837
Phone (413) 297-6682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1980 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 082-PA | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586131200000",
"number": "1548899131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 EDBERT ST APT C",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010202837",
"telephone_number": "413-297-6682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 EDBERT ST APT C",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010202837",
"telephone_number": "413-297-6682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMAS",
"first_name": "JEAN BETTEL",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-06",
"last_updated": "2020-04-06",
"certification_date": "2020-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "082-PA",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1980",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicopee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.