Individual provider Active NPI

Alex Betz, PMHNP

  • Psychiatry Physician
  • Toledo, OH
National Provider Identifier
1952905929
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
APRN.CNP.0028090 Issued in OH
Practice address
3130 Executive Pkwy FL 8
Toledo, OH 43606-5530
Phone
(419) 720-9000
NPI assigned
Nov 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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 APRN.CNP.0028090 OH Primary

Addresses

Primary practice location

3130 Executive Pkwy FL 8
Toledo, OH 43606-5530

Mailing address

6110 N Winding Way
Swanton, OH 43558-9581
Phone (419) 205-7330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210806001380 CO Practitioner - Nurse Practitioner 0244634624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joseph Yeretsian PCGroup PAC ID 5597893313, 13 clinicians

Practice addresses (Care Compare)

155 Boardwalk Dr
Suite 400
Fort Collins, CO 80525-3040
Phone (970) 549-0235

4770 Baseline Rd
Suite 300
Boulder, CO 80303-2669
Phone (720) 798-4516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0028090OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Yeretsian, P.C. CurrentSince May 3, 2022 Accepting new patients

Locations

4770 Baseline Rd
Ste 300
Boulder, CO 80303
Phone (720) 798-4516

155 Boardwalk Dr
Ste 400
Fort Collins, CO 80525
Phone (970) 549-0235

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1952905929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 N WINDING WAY",
            "city": "SWANTON",
            "state": "OH",
            "postal_code": "435589581",
            "telephone_number": "419-205-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 EXECUTIVE PKWY FL 8",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065530",
            "telephone_number": "419-720-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETZ",
        "first_name": "ALEX",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "APRN.CNP.0028090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.