Individual provider Active NPI

Bethany Layne Stevermer, PA-C

  • Physician Assistant
  • Willmar, MN
National Provider Identifier
1790223873
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57910 Issued in MN
Practice address
1801 19TH Ave SW
Willmar, MN 56201-4946
Phone
(320) 231-3277
Fax
(320) 214-5758
NPI assigned
Feb 8, 2017
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57910 MN Primary

Addresses

Primary practice location

1801 19TH Ave SW
Willmar, MN 56201-4946

Mailing address

1801 19TH Ave SW
Willmar, MN 56201-4946
Phone (320) 231-3277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170825003337 MN Practitioner - Physician Assistant 0143592048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, shared by 13 NPIs, 156 clinicians
Janning ENT Center, LLCGroup PAC ID 5496788077, 4 clinicians

Practice addresses (Care Compare)

1521 Carlson St
Suite 100
Marshall, MN 56258-2626
Phone (507) 473-4800

1801 19TH Ave SW
Willmar, MN 56201-4946
Phone (320) 231-3277

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.38 of 100Reported as group
Quality
78.88
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57910MNMDPsychiatry Physician
12378MNMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: bethany.stevermer@avera.sdhealthlink.net

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.

Hospital & facility affiliations 4

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": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1790223873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014946",
            "telephone_number": "320-231-3277",
            "fax_number": "320-214-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014946",
            "telephone_number": "320-231-3277",
            "fax_number": "320-214-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVERMER",
        "first_name": "BETHANY",
        "middle_name": "LAYNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "57910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.