Active NPI
Maria Paula Betancur, PA-C
- Physician Assistant
- Independence, MO
National Provider Identifier
1992325930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2023013212
- Practice address
- 19600 E 39TH St S
Independence, MO 64057-2301 - Phone
- (913) 222-9779
- NPI assigned
- Apr 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9115193 | FL | |
| Physician Assistant | 363A00000X | 2023013212 | MO | Primary |
Addresses
Primary practice location
19600 E 39TH St S
Independence, MO 64057-2301
Mailing address
19600 E 39TH St S
Independence, MO 64057-2301
Phone (913) 222-9779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230503002948 | MO | Practitioner - Physician Assistant | 8325439318 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9115193 | FL | MD | Physician Assistant |
| 2023013212 | MO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| P & C Consultant Services | Past | Accepting new patients |
Interoperability endpoints
- maria.betancur.p32@direct.medcor.nextgenshare.com
- https://fhir4.healow.com/fhir/r4/DHAEDD
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 and National Provider Directory roles.
-
- Pulmonary Disease Physician
- Independence, MO
- NPI 1073204673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1992325930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19600 E 39TH ST S",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640572301",
"telephone_number": "913-222-9779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19600 E 39TH ST S",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640572301",
"telephone_number": "913-222-9779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETANCUR",
"first_name": "MARIA",
"middle_name": "PAULA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-20",
"last_updated": "2023-07-06",
"certification_date": "2023-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9115193",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2023013212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.