Individual provider Active NPI

Roy Joseph Betti, M.D.

  • Pediatrics Physician
  • Wheaton, IL
National Provider Identifier
1831123801
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
36043734 Issued in IL
Practice address
2001 N Gary Ave
Wheaton, IL 60187-3055
Phone
(630) 653-5115
Fax
(630) 653-4493
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 36043734 IL Primary

Addresses

Primary practice location

2001 N Gary Ave
Wheaton, IL 60187-3055

Mailing address

2001 N Gary Ave
Wheaton, IL 60187-3055
Phone (630) 653-5115

Other identifiers 3

IdentifierTypeStateIssuer
036043734MedicaidIL
920540007OtherILMEDICARE PTAN (INDIVIDUAL)
920540OtherILMEDICARE PTAN (GROUP)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090506000198 IL Practitioner - Pediatric Medicine 7214085935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

2001 N Gary Ave
Wheaton, IL 60187-3055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36043734ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Aug 2, 2010 Accepting new patients
Central Dupage Physician Group Pediatrics CurrentSince Aug 2, 2010 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

2001 N Gary Ave
Ste 100
Wheaton, IL 60187
Phone (630) 614-4100

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

2001 N Gary Ave
Wheaton, IL 60187
Phone (630) 614-4100

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1831123801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GARY AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873055",
            "telephone_number": "630-653-5115",
            "fax_number": "630-653-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N GARY AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873055",
            "telephone_number": "630-653-5115",
            "fax_number": "630-653-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTI",
        "first_name": "ROY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "36043734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036043734",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "920540007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "920540",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.