NPIMap

Individual provider Active NPI

Bryan Paul Beaver, M.D.

  • Emergency Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1104183482
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2014-02229 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-5222
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 2014-02229 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

817 Bellview St
Winston Salem, NC 27103-3505
Phone (913) 952-4669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150612000342 NC Practitioner - Emergency Medicine 8325359623 Reassigns benefits to 1 organization
I20200805001303 KS Practitioner - Emergency Medicine 8325359623 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-02229NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kansas Hospital Authority CurrentSince Jul 1, 2020 Accepting new patients
University of Kansas Hospital Authority CurrentSince Jul 1, 2020 Accepting new patients
Wake Forest Emergency Providers CurrentSince Sep 9, 2019 Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

11300 Corporate Ave
Ste 330
Lenexa, KS 66219
Phone (913) 588-6111

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: bbeaver23720@direct.kuha.org

Organizations & group practices 12

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 2

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

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Kansas Hospital Authority 243 clinicians

Practice addresses (Care Compare)

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-5000

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1104183482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 BELLVIEW ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033505",
            "telephone_number": "913-952-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "BRYAN",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2014-02229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.