Individual provider Active NPI

Maralys Colon Betancourt, MD

  • Psychiatry Physician
  • Lincolnshire, IL
National Provider Identifier
1902359177
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
326216 Issued in LA
Practice address
250 Parkway Dr Ste 150
Lincolnshire, IL 60069-4340
Phone
(833) 351-8255
NPI assigned
Jul 25, 2016
Last updated
Apr 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 332203 NY
Psychiatry Physician 2084P0800X 036171479 IL
Psychiatry Physician 2084P0800X MD487133 PA
Psychiatry Physician 2084P0800X 01087793A IN
Psychiatry Physician 2084P0800X 326216 LA Primary

Addresses

Primary practice location

250 Parkway Dr Ste 150
Lincolnshire, IL 60069-4340

Mailing address

PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255

Other practice location 1

2418 E York St
Philadelphia, PA 19125-3006
Phone (833) 351-8255

Other practice location 2

550 Congressional Blvd Ste 115
Carmel, IN 46032-5644
Phone (833) 351-8255

Other practice location 3

109 W 27th St Ste 5S
New York, NY 10001-0265
Phone (833) 351-8255

Other practice location 4

206 N Randolph St Ste 2
Champaign, IL 61820-3976
Phone (833) 351-8255

Other practice location 5

680 American Ave Ste 302
King Of Prussia, PA 19406-4023
Phone (833) 351-8255

Other identifiers 1

IdentifierTypeStateIssuer
300062263MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220607000790 IN Practitioner - Psychiatry 8123436185 Reassigns benefits to 1 organization
I20241002002307 IL Practitioner - Psychiatry 8123436185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Puerto Rico School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

250 Pkwy Dr
Suite 150
Lincolnshire, IL 60069-4340
Phone (833) 351-8255

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
MCCD FL Psychiatry Services PA Single Specialty CurrentSince Sep 23, 2024 Accepting new patients

Locations

206 N Randolph St
Ste 2
Champaign, IL 61820
Phone (540) 892-0910

250 Parkway Dr
Ste 150
Lincolnshire, IL 60069
Phone (847) 480-1346

550 Congressional Blvd
Ste 115
Carmel, IN 46032

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

680 American Ave
Ste 302
King of Prussia, PA 19406
Phone (215) 714-3418

2418 E York St
Philadelphia, PA 19125
Phone (215) 575-5906

Organizations & group practices 2

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": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1902359177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARKWAY DR STE 150",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600694340",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2418 E York St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191253006",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Congressional Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460325644",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 W 27th St Ste 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100010265",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 N Randolph St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618203976",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 American Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194064023",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLON BETANCOURT",
        "first_name": "MARALYS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "332203",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036171479",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD487133",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01087793A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "326216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300062263",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnshire, IL

Sources for this page

Verify at the official NPI Registry.