NPIMap

Individual provider Active NPI

Scott J Beougher, DO

  • Family Medicine Physician
  • Oshkosh, WI
National Provider Identifier
1063421683
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47066 Issued in WI
Practice address
5165 Chesapeake CT
Oshkosh, WI 54901-1329
Phone
(920) 303-2254
NPI assigned
Aug 5, 2006
Last updated
May 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47066 WI Primary
Family Medicine Physician 207Q00000X 5101014920 MI

Addresses

Primary practice location

5165 Chesapeake CT
Oshkosh, WI 54901-1329

Mailing address

5165 Chesapeake CT
Oshkosh, WI 54901-1329
Phone (920) 303-2254

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120222000403 CO Practitioner - Family Practice 8729050208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ponderosa Family Physicians PCGroup PAC ID 1658261854, 8 clinicians

Practice addresses (Care Compare)

14991 E Hampden Ave
Suite 210
Aurora, CO 80014-3985
Phone (303) 690-4891

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101014920MIMDFamily Medicine Physician
47066WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ponderosa Family Physicians PC Family Medicine CurrentSince Feb 8, 2012 Accepting new patients

Locations

14991 E Hampden Ave
Ste 210
Aurora, CO 80014
Phone (303) 690-4891

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HICCCA/Endpoint/HICCCA

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1063421683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5165 CHESAPEAKE CT",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011329",
            "telephone_number": "920-303-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5165 CHESAPEAKE CT",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011329",
            "telephone_number": "920-303-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEOUGHER",
        "first_name": "SCOTT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "47066",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.