Emma Grace Beasley, DO
Individual provider Active NPI Emergency Medicine Physician · Wyandotte, MI
NPI 1053949677 · NPPES record last updated Jun 25, 2020
Key facts
- NPI
- 1053949677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 5151014409 (MI)
- Practice address
- 2333 Biddle Ave
Wyandotte, MI 48192-4668 - Phone
- (734) 246-8004
- NPI assigned
- Mar 30, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Henry Ford Health System
Practice addresses (Care Compare)
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100
Hospital & facility affiliations
- Henry Ford Health West Bloomfield Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20230706003882 | MI | Practitioner - Emergency Medicine | 9739548868 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5151014409 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Pathology | Current | Accepting new patients | |
| Henry Ford Health System | Emergency Medicine | Current |
Accepting new patients |
| Henry Ford Health System | Current |
Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients |
Locations
19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000
2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000
Interoperability endpoints
- ebeasley607010@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 5151014409 | MI | Yes |
Addresses
Primary practice location
2333 Biddle Ave
Wyandotte, MI 48192-4668
Mailing address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-8004
Other providers in Wyandotte, MI
- Jennifer Barry
- Brittany Barto
- Lindsey Guerriero Battistelli
- Zeinab Bazzi
- Jana Bazzoun
- Ashley Nicole Beaudette
- Begin Again Therapy LLC
- Benson Dental LLC
- Daniel M. Benson
- Bestcare Home Health Dba Kenny Rehab Inc
All providers in Wyandotte, MI · Emergency Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2020. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.