NPIMap

Organization Active NPI

Mentus Behavioral Health LLC

  • Child & Adolescent Psychiatry Physician
  • Fort Myers, FL
National Provider Identifier
1700533536
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
MENTUS BEHAVIORAL HEALTH LLC
Practice address
12651 McGregor Blvd Ste 301
Fort Myers, FL 33919-4488
Phone
(704) 770-7027
NPI assigned
Mar 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Dr. Luis Emilio Betancourt, MDNPI 1891076022
Title
Chief Medical Officer
Phone
(704) 770-7027

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

12651 McGregor Blvd Ste 301
Fort Myers, FL 33919-4488

Mailing address

12651 McGregor Blvd Ste 301
Fort Myers, FL 33919-4488
Phone (704) 770-7027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220808002082 FL Part B Supplier - Clinic/Group Practice 0143602110 Receives reassigned benefits from 6 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

12651 McGregor Blvd
Ste 301
Fort Myers, FL 33919
Phone (239) 314-3223

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1700533536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12651 MCGREGOR BLVD STE 301",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194488",
            "telephone_number": "704-770-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12651 MCGREGOR BLVD STE 301",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194488",
            "telephone_number": "704-770-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTUS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "BETANCOURT",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "EMILIO",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "704-770-7027",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.