MS. BETHANY NELSON (PA-C) – Surgical Physician Assistant, NPI 1912217415
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
780 PHYSICIAN ASSISTANT in RI
Provider Addresses for MS. BETHANY NELSON (PA-C)
PO BOX 16149
RUMFORD, RI 029160697
Phone: (401) 453-9625
Fax: (401) 435-7069
Type: Mailing
164 SUMMIT AVE
C70
PROVIDENCE, RI 029062853
Phone: (401) 793-4545
Fax: (401) 793-7866
Type: Location
143 Longwater Dr
Norwell, MA 020611683
Phone: (781) 878-5200
Type: Location
780 Main St
Weymouth, MA 021901622
Phone: (781) 331-4600
Type: Location
55 Fogg Rd
Weymouth, MA 021902432
Phone: (781) 624-8000
Type: Location
2 Pond Park Rd
Hingham, MA 020434347
Phone: (781) 624-8352
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-10-20
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130102000005 | I | Physician Assistant | RI | TBD |
| I20151020002700 | I | Physician Assistant | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02916)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MA | |
| - | MA | |
| - | MA | |
| U R O L O G Y | MA | |
| Family Practice | MA | |
| Physician Assistant | MA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA | |
| - | MA | |
| - | MA | |
| U R O L O G Y | MA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.