Individual provider Active NPI

Bethany Cassidy, RN

  • Family Nurse Practitioner
  • Plymouth Meeting, PA
National Provider Identifier
1669828729
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017451 Issued in PA
Practice address
2901 Jolly Rd
Plymouth Meeting, PA 19462
Phone
(610) 272-8221
Fax
(610) 272-5655
NPI assigned
May 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN601676 PA
Family Nurse Practitioner 363LF0000X SP017451 PA Primary

Addresses

Primary practice location

2901 Jolly Rd
Plymouth Meeting, PA 19462

Mailing address

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 279-1453

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170612000157 PA Practitioner - Nurse Practitioner 2365710621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acts Signature Community Services IncGroup PAC ID 5092032284, 34 clinicians
Acts Retirement-Life Communities IncGroup PAC ID 1951212380, 34 clinicians

Practice addresses (Care Compare)

1343 W Baltimore Pike
Primary Care Services at Granite Farms Esta
Media, PA 19063-5519
Phone (610) 358-3440

9000 Twin Silo Dr
Blue Bell, PA 19422-4202
Phone (215) 699-8721

Hospital & facility affiliations

  • Acts Home Health Agency of Pennsylvania Home health agency, Fort Washington, PA, CCN 398265
  • Willowbrooke Ctskdcarectr Atnormandy Farms Estates Nursing home, Blue Bell, PA, CCN 395665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN601676PAMDRegistered Nurse
SP017451PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acts Signature Community Services, Inc. CurrentSince Aug 29, 2022 Accepting new patients
Acts Signature Community Services, Inc. Current Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Nov 18, 2019 Accepting new patients
Acts Signature Community Services, Inc. CurrentSince Aug 29, 2022 Accepting new patients
HCR Manor Care Medical Services of Florida LLC CurrentSince Nov 18, 2019 Accepting new patients

Locations

L2540
Columbus, OH 43260

60 Highland Rd
Bethel Park, PA 15102
Phone (412) 531-6050

9000 Twin Silo Dr
Blue Bell, PA 19422
Phone (215) 699-8721

420 Delaware Dr
Ft Washington, PA 19034
Phone (215) 661-8330

3430 Huntingdon Pike
Huntingdon Vy, PA 19006
Phone (215) 938-7171

Interoperability endpoints

  • Direct secure messaging: bethany.cassidy.p1@direct.actslife.nextgenshare.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1669828729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324",
            "telephone_number": "610-279-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "19462",
            "telephone_number": "610-272-8221",
            "fax_number": "610-272-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "BETHANY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN601676",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.