Individual provider Active NPI

Steven J Bethka, O.D.

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1639136120
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1394 Issued in CO
Practice address
950 North Ave Ste 106
Grand Junction, CO 81501-3259
Phone
(970) 245-7850
Fax
(970) 242-0281
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1394 CO Primary

Addresses

Primary practice location

950 North Ave Ste 106
Grand Junction, CO 81501-3259

Mailing address

950 North Ave Ste 106
Grand Junction, CO 81501-3259
Phone (970) 245-7850

Other practice location 1

1144 N 12th St
Grand Junction, CO 81501-7641
Phone (970) 245-7850

Other identifiers 2

IdentifierTypeStateIssuer
08013948MedicaidCO
P00323440OtherCORAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000647 CO Practitioner - Optometry 3375506892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Vision Center, Inc.Group PAC ID 1456395359, 6 clinicians

Practice addresses (Care Compare)

950 N Ave
Suite 106
Grand Junction, CO 81501-7641
Phone (970) 242-0222

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1394COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Vision Center, Inc. Optometrist Current Accepting new patients
Valley Vision Center, Inc. CurrentSince Jan 31, 2005 Accepting new patients

Locations

1144 N 12th St
Grand Junction, CO 81501
Phone (970) 242-3443

362 Main St
Grand Junction, CO 81501
Phone (970) 245-6688

950 North Ave
Ste 106
Grand Junction, CO 81501
Phone (970) 242-0222

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1639136120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 NORTH AVE STE 106",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815013259",
            "telephone_number": "970-245-7850",
            "fax_number": "970-242-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 NORTH AVE STE 106",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815013259",
            "telephone_number": "970-245-7850",
            "fax_number": "970-242-0281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1144 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815017641",
            "country_code": "US",
            "telephone_number": "970-245-7850",
            "fax_number": "970-242-0281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETHKA",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08013948",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00323440",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.