Individual provider Active NPI

Amy J Bettencourt

  • Case Manager/Care Coordinator
  • Boston, MA
National Provider Identifier
1811593452
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
774 Albany St
Boston, MA 02118-3551
Phone
(617) 534-6126
Fax
(857) 288-2240
NPI assigned
Dec 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

774 Albany St
Boston, MA 02118-3551

Mailing address

1010 Massachusetts Avenue
Boston, MA 02118-2600
Phone (617) 534-3134

Other names 1

  • Alex Bettencourt Other name

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1811593452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MASSACHUSETTS AVENUE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182600",
            "telephone_number": "617-534-3134",
            "fax_number": "857-288-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183551",
            "telephone_number": "617-534-6126",
            "fax_number": "857-288-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTENCOURT",
        "first_name": "AMY",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "BETTENCOURT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.