Individual provider Active NPI

Maria Camila Agudelo Betancur, APRN

  • Family Nurse Practitioner
  • Cleburne, TX
National Provider Identifier
1780485177
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1193503 Issued in TX
Practice address
895 N Nolan River Rd Ste 102
Cleburne, TX 76033-1250
Phone
(817) 556-9700
Fax
(817) 556-9702
NPI assigned
Mar 21, 2025
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1193503 TX Primary

Addresses

Primary practice location

895 N Nolan River Rd Ste 102
Cleburne, TX 76033-1250

Mailing address

9121 Blakely Dr
Fort Worth, TX 76134-1654
Phone (817) 846-7406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250506003399 TX Practitioner - Nurse Practitioner 6103343819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alazar Medical Group, PLLCGroup PAC ID 3678702867, 6 clinicians

Practice addresses (Care Compare)

895 N Nolan River Rd
Suite 102
Cleburne, TX 76033-1250
Phone (817) 556-9700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1193503TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alazar Medical Group, PLLC CurrentSince May 1, 2025 Accepting new patients

Locations

895 N Nolan River Rd
Ste 102
Cleburne, TX 76033
Phone (817) 556-9700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAEJCA

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1780485177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9121 BLAKELY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761341654",
            "telephone_number": "817-846-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 N NOLAN RIVER RD STE 102",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760331250",
            "telephone_number": "817-556-9700",
            "fax_number": "817-556-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUDELO BETANCUR",
        "first_name": "MARIA",
        "middle_name": "CAMILA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1193503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.