Individual provider Active NPI

Ronald Duane Beesley, M.D.

  • Reproductive Endocrinology Physician
  • Kirkland, WA
National Provider Identifier
1023063013
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
60174021 Issued in WA
Practice address
12039 NE 128TH St Ste 110
Kirkland, WA 98034-3034
Phone
(425) 822-7662
Fax
(425) 822-0172
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 60174021 WA Primary

Addresses

Primary practice location

12039 NE 128TH St Ste 110
Kirkland, WA 98034-3034

Mailing address

12039 NE 128TH St Ste 110
Kirkland, WA 98034-3034
Phone (425) 822-7662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180823001080 WA Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 6507950409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60174021WAMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poma Fertility Medical Associates, PLLC PastSince Aug 1, 2021 Accepting new patients
Poma Fertility, LLC PastSince Aug 1, 2021 Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1023063013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 110",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343034",
            "telephone_number": "425-822-7662",
            "fax_number": "425-822-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 110",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343034",
            "telephone_number": "425-822-7662",
            "fax_number": "425-822-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEESLEY",
        "first_name": "RONALD",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "WA",
            "license": "60174021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.