Beth A Besaw, MD
Individual provider Active NPI Family Medicine Physician · Defiance, OH
NPI 1013900950 · NPPES record last updated Apr 30, 2012
Key facts
- NPI
- 1013900950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35075892 (OH)
- Practice address
- 1250 Ralston Ave
Suite 104
Defiance, OH 43512-5311 - Phone
- (419) 783-6995
- Fax
- (419) 784-1606
- NPI assigned
- Aug 25, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260403000342 | OH | Order and Referring Only - Hospice/Palliative Care |
1658347638 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35075892 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35075892 | OH | Yes |
Addresses
Primary practice location
1250 Ralston Ave
Suite 104
Defiance, OH 43512-5311
Mailing address
1250 Ralston Ave
Suite 104
Defiance, OH 43512-5311
Phone (419) 783-6995
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2166507 | Medicaid | OH | |
| 000000340015 | Other | OH | ANTHEM |
| 7656122 | Other | OH | AETNA |
| 2-95562 | Other | OH | UHC |
| P00158158 | Other | OH | RRMC |
| 03593 | Other | OH | PHC |
Other providers in Defiance, OH
- Terri Bendele
- Cassandra Bengela
- Denise Benore
- Lanee Benson
- Nicole Bernath
- Heidi Betz
- Zainab Abdulhusen Bhagat
- Jessica Biegel
- Andrew Bilen
- Julia Birkemeier
All providers in Defiance, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.