Individual provider Active NPI

Marta N Betancourt

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1912924416
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME95635 Issued in FL
Practice address
445 E 25TH St
Hialeah, FL 33013-3810
Phone
(305) 642-5366
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME95635 FL Primary

Addresses

Primary practice location

445 E 25TH St
Hialeah, FL 33013-3810

Mailing address

445 E 25TH St
Hialeah, FL 33013-3810
Phone (305) 642-5366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20061229000378 FL Practitioner - Family Practice 0749280568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leon Medical Centers LLCGroup PAC ID 9537066618, 108 clinicians

Practice addresses (Care Compare)

11501 SW 40 St
Miami, FL 33165-3313
Phone (305) 642-5366

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Moments Hospice of Miami LLC Hospice, Miami Lakes, FL, CCN 101566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME95635FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Sep 2, 2006 Accepting new patients

Locations

8600 NW 41st St
Doral, FL 33166
Phone (305) 642-1511

445 E 25th St
Hialeah, FL 33013
Phone (305) 646-3756

11501 SW 40th St
Miami, FL 33165
Phone (305) 646-3716

101 SW 27th Ave
Miami, FL 33135
Phone 30564253662155

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912924416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133810",
            "telephone_number": "305-642-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133810",
            "telephone_number": "305-642-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "MARTA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME95635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.