Individual provider Active NPI

Brian Beals, MD

  • Pediatrics Physician
  • Gorham, NH
National Provider Identifier
1104828979
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9177 Issued in NH
Practice address
2 Broadway Ave
Gorham, NH 03581-1502
Phone
(603) 466-2741
Fax
(603) 466-2953
NPI assigned
Aug 11, 2005
Last updated
Sep 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9177 NH Primary

Addresses

Primary practice location

2 Broadway Ave
Gorham, NH 03581-1502

Mailing address

133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20091023000120 NH Practitioner - Pediatric Medicine 1052458023 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Broadway Ave
Gorham, NH 03581-1502
Phone (603) 466-2741

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9177NHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince May 1, 2021 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Sep 5, 2009 Accepting new patients
Coos County Family Health Services, Inc CurrentSince Aug 23, 2017 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Sep 5, 2009 Accepting new patients
Dartmouth-Hitchcock Clinic Pediatrics CurrentSince May 1, 2021 Accepting new patients
Coos County Family Health Services, Inc CurrentSince Aug 23, 2017 Accepting new patients
Androscoggin Valley Hospital Inc CurrentSince Sep 5, 2009 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince May 1, 2021 Accepting new patients
Coos County Family Health Services, Inc Pediatrics Past Accepting new patients
Coos County Family Health Services, Inc. Pediatrics Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Pleasant St
Berlin, NH 03570
Phone (603) 752-2040

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

7 Page Hill Rd
Berlin, NH 03570
Phone (603) 326-5827

2 Broadway Ave
Gorham, NH 03581
Phone (603) 466-2741

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1104828979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PLEASANT ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702006",
            "telephone_number": "603-752-2040",
            "fax_number": "603-752-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BROADWAY AVE",
            "city": "GORHAM",
            "state": "NH",
            "postal_code": "035811502",
            "telephone_number": "603-466-2741",
            "fax_number": "603-466-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALS",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "9177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, NH

Sources for this page

Verify at the official NPI Registry.