DOMINIQUE K BETHEA NP
NPI 1396201885
Nurse Practitioner - Family in Lawrenceville, GA

Q: What is Dominique Bethea's NPI number?

The NPI number for Dominique Bethea is 1396201885. It was assigned to this individual provider in the NPPES registry on February 20, 2019.

Q: What is Dominique Bethea's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Dominique Bethea was last updated on April 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 20, 2019PECOS Enrolled

771 OLD NORCROSS RD STE 200, LAWRENCEVILLE, GA 30046(770) 339-1387(770) 962-7868 Get Directions Write a Review

NPPES record last updated: April 13, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 13, 2023, Jun 20, 2020, Feb 20, 2019 (3 updates tracked since 2019).

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About Dominique K Bethea Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINIQUE K BETHEA NP (NPI 1396201885) is an individual family provider in Lawrenceville, Georgia, licensed in Georgia (RN281107) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396201885

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDOMINIQUE K BETHEACredential: NP

Location Address771 OLD NORCROSS RD STE 200Lawrenceville, GA 30046-4980

Mailing Address771 Old Norcross Rd Ste 200Lawrenceville, GA 30046-4980 · (770) 339-1387 · Fax (770) 962-7868

Phone(770) 339-1387

Fax(770) 962-7868

Sole ProprietorNo

Enumeration DateFebruary 20, 2019

Last NPPES UpdateApril 13, 20233 updates tracked since enumeration

NPPES CertifiedApril 13, 2023

✔ NPI 1396201885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN281107

771 OLD NORCROSS RD STE 200, Lawrenceville, GA 30046

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dominique K Bethea Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

23 suppliers49 claims152 services$6.31 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

15 suppliers30 claims42 services$1.12 avg. paid by Medicare

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

2 suppliers25 claims25 services$306.90 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

8 suppliers47 claims47 services$181.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOOR KHAN

Physician Assistant