Individual provider Active NPI

Bradley I Bettinger, M.D.

  • Diagnostic Radiology Physician
  • San Francisco, CA
National Provider Identifier
1700804325
Registry record updated Aug 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G18780 Issued in CA
Practice address
4022 Cesar Chavez St
San Francisco, CA 94131-1919
Phone
(415) 550-1731
Fax
(415) 647-1766
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G18780 CA Primary

Addresses

Primary practice location

4022 Cesar Chavez St
San Francisco, CA 94131-1919

Mailing address

4022 Cesar Chavez St
San Francisco, CA 94131-1919
Phone (415) 550-1731

Other identifiers 1

IdentifierTypeStateIssuer
G18780OtherCAPHYSICIAN & SURGEON CERT

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18780CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186790400000",
    "number": "1700804325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 CESAR CHAVEZ ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941311919",
            "telephone_number": "415-550-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 CESAR CHAVEZ ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941311919",
            "telephone_number": "415-550-1731",
            "fax_number": "415-647-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTINGER",
        "first_name": "BRADLEY",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G18780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN & SURGEON CERT",
            "identifier": "G18780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.