Individual provider Active NPI

Pedro A. Betances, MD

  • General Practice Physician
  • The Villages, FL
National Provider Identifier
1922004647
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14292 Issued in PR
Practice address
8900 SE 165TH Mulberry LN
North Florida / South Georgia Veterans Health System
The Villages, FL 32162-5884
Phone
(352) 674-5053
Fax
(352) 674-5001
NPI assigned
Jun 27, 2005
Last updated
Dec 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14292 PR Primary

Addresses

Primary practice location

8900 SE 165TH Mulberry LN
North Florida / South Georgia Veterans Health System
The Villages, FL 32162-5884

Mailing address

8900 SE 165TH Mulberry LN
North Florida / South Georgia Veterans Health System
The Villages, FL 32162-5884
Phone (352) 674-5053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140215000146 TX Order and Referring Only - General PracticePractitioner - General Practice 5991692915

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14292PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital General San Carlos,Inc. Past Accepting new patients

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1922004647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 SE 165TH MULBERRY LN",
            "address_2": "NORTH FLORIDA / SOUTH GEORGIA VETERANS HEALTH SYSTEM",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625884",
            "telephone_number": "352-674-5053",
            "fax_number": "352-674-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 SE 165TH MULBERRY LN",
            "address_2": "NORTH FLORIDA / SOUTH GEORGIA VETERANS HEALTH SYSTEM",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625884",
            "telephone_number": "352-674-5053",
            "fax_number": "352-674-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCES",
        "first_name": "PEDRO",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.