Timothy L Beechnau, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

008430 Issued in MI

Practice address

12520 Crockery Creek Dr.
Ravenna, MI 49451

Phone

(231) 853-6725

Fax

(231) 853-6089

NPI assigned

Jun 16, 2005

Reactivated

Mar 29, 2006

Last updated

Mar 8, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

General Practice

Education

Michigan State University College of Osteopathic Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ravenna Family Practice PCGroup PAC ID 8224023148, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harbor Hospice Hospice, Muskegon, MI, CCN 231508
• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

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.

• Ravenna Family Practice, P.C.

  • Family Medicine Physician
  • Ravenna, MI
  • NPI 1497928469
  Medicare reassignment Care Compare group NPD Authorized official
• Mercy Physician Network

  • Family Medicine Physician
  • Muskegon, MI
  • NPI 1023056744
  Medicare reassignment NPD
• Mercy Physician Network

  dba Fruitport Family Medicine

  • Family Medicine Physician
  • Fruitport, MI
  • NPI 1639502701
  NPD

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

• Hospice of Muskegon County, Inc.

  dba Harbor Hospice

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Muskegon, MI
  • NPI 1740283787
  Care Compare affiliation
• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1083619936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "RAVENNA",
            "state": "MI",
            "postal_code": "494510179",
            "telephone_number": "231-853-6725",
            "fax_number": "231-853-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 CROCKERY CREEK DR.",
            "city": "RAVENNA",
            "state": "MI",
            "postal_code": "49451",
            "telephone_number": "231-853-6725",
            "fax_number": "231-853-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEECHNAU",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-03-08",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "008430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5610010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4098417",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "5610010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "383249263",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "383249263",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4480790",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Apple Family Medicine, P.L.C.
• Nicholas S Beechnau, D.O.
• Joseph Thomas Bristol, RPH
• Craig Robert Cameron, D.D.S.
• Craig R Cameron DDS PLC
• Crockery Creek Elder Care, Inc
• Anita Curtis-Macdonald, D.C.

• Family Medicine Physician in Ravenna, MI
• Providers in Ravenna, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.