Bethany Desroches, MD, MS

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA10578000 Issued in NJ

Practice address

360 Essex St Ste 403
Hackensack, NJ 07601-8566

Phone

(551) 996-2667

NPI assigned

May 12, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  Urology

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Psychologist
  • Red Bank, NJ
  • NPI 1609593722
  NPD (past)
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1043224355
  NPD (past)
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1982015020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST STE 403",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018566",
            "telephone_number": "551-996-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST STE 403",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018566",
            "telephone_number": "551-996-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESROCHES",
        "first_name": "BETHANY",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10050157",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA10578000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "BP10050157",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ MEDICAL LICENSE",
            "identifier": "25MA10578000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivek Arvind Desai, PA-C
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• Designing Smiles LLC
• Karen Deslouches, MD
• Alyssa Destefano, NP
• Phillip Sunil Devadan, M.D.
• Megan Devlin, NP
• Devon'S Promise Inc
• Shoshana Malka Devor, MD

• Urology Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.