Individual provider Active NPI

R Ellen Bettigole, MD

  • Psychiatry Physician
  • Troy, NY
National Provider Identifier
1891841516
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
198099-01 Issued in NY
Practice address
1600 7TH Ave
Troy, NY 12180-3410
Phone
(518) 270-2800
Fax
(518) 270-2723
NPI assigned
Jan 26, 2007
Last updated
Apr 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 198099-01 NY Primary

Addresses

Primary practice location

1600 7TH Ave
Troy, NY 12180-3410

Mailing address

1600 7TH Ave
Troy, NY 12180-3410
Phone (518) 270-2800

Other identifiers 1

IdentifierTypeStateIssuer
198099-01OtherNYSTATE OF NEW YORK LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120201000487 NY Practitioner - Psychiatry 6002073129 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198099-01NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rensselaer County Bureau of Finance CurrentSince Oct 1, 1999 Accepting new patients

Locations

1600 7th Ave
Troy, NY 12180
Phone (518) 270-2800

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1891841516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121803410",
            "telephone_number": "518-270-2800",
            "fax_number": "518-270-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121803410",
            "telephone_number": "518-270-2800",
            "fax_number": "518-270-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTIGOLE",
        "first_name": "R",
        "middle_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "198099-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW YORK LICENSE",
            "identifier": "198099-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.