Individual provider Active NPI

Matthew C. Bean, MD

  • Family Medicine Physician
  • Coeur D Alene, ID
National Provider Identifier
1053675009
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M13757 Issued in ID
Practice address
1919 Lincoln Way Ste 315
Coeur D Alene, ID 83814-2527
Phone
(208) 625-6000
Fax
(208) 625-6001
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M13757 ID Primary

Addresses

Primary practice location

1919 Lincoln Way Ste 315
Coeur D Alene, ID 83814-2527

Mailing address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-5085

Other identifiers 2

IdentifierTypeStateIssuer
032402MedicaidAZ
R73512OtherAZTRAINING PERMIT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbean609487@direct.multicare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20170630001099 ID Practitioner - Family Practice 5193039113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kootenai Health Inc 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

1919 Lincoln Way
Coeur D Alene, ID 83814-2527

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Hospital & facility affiliations

  • Hospice of North Idaho Hospice, Coeur D Alene, ID, CCN 131504
  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions23
Removal or shaving of skin growth1-10
Skin biopsy22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Jun 26, 2017 Accepting new patients
Kootenai Health, Inc. CurrentSince Jun 26, 2017 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1919 Lincoln Way
Ste 315
Coeur D Alene, ID 83814
Phone (208) 625-6000

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Interoperability endpoints

  • Direct secure messaging: mbean609487@direct.multicare.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1053675009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-5085",
            "fax_number": "208-625-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LINCOLN WAY STE 315",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142527",
            "telephone_number": "208-625-6000",
            "fax_number": "208-625-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "MATTHEW",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M13757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032402",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R73512",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbean609487@direct.multicare.org",
            "affiliation": "N",
            "address_1": "1919 Lincoln Way Ste 315",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.