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Bethlehem A. Kassaye

Family Medicine

Allopathic & Osteopathic Physicians

1601 Owen Dr, Fayetteville, NC 28304-3425

PECOS Enrollment

This provider is enrolled in PECOS as BETHLEHEM KASSAYE.

Based on the most recent information from CMS, provider Bethlehem A. Kassaye is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1952759375
Provider Type
Individual
Full Name
Kassaye, Bethlehem A.
Credential
D.O.

Gender
Female
Sole Proprietor
No
Enumeration Date
5/26/2016
Last Updated
2/15/2022

Contact Information

Practice Location

1601 Owen Dr, Fayetteville, NC 28304-3425

(910) 678-0100

(910) 678-0115

Mailing Location

1601 Owen Dr, Fayetteville, NC 28304-3425

(910) 678-0100

(910) 678-0115

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License H0086961 Maryland
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 217771 North Carolina

Bethlehem A. Kassaye

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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License

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