NPIMap

Individual provider Active NPI

Bryan James Beardsley, M.D.

  • Orthopaedic Surgery Physician
  • Clarkston, WA
National Provider Identifier
1104856087
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
M9722 Issued in ID
Practice address
1207 Evergreen CT
Clarkston, WA 99403-2874
Phone
(509) 769-2255
Fax
(509) 769-2255
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X M9722 ID Primary
Orthopaedic Surgery Physician 207X00000X MD00044939 WA

Addresses

Primary practice location

1207 Evergreen CT
Clarkston, WA 99403-2874

Mailing address

PO Box 189
Clarkston, WA 99403-0189
Phone (509) 769-2254

Other identifiers 4

IdentifierTypeStateIssuer
807636400MedicaidID
8169918MedicaidWA
76800OtherIDBLUECROSS OF IDAHO
000010159447OtherIDREGENCE BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 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
I20050802000559 WA Practitioner - Orthopedic Surgery 7810925658 Reassigns benefits to 3 organizations
I20070501000221 ID Practitioner - Orthopedic Surgery 7810925658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-State Memorial Hospital 33 clinicians
Catalyst Medical Group PLLC 31 clinicians

Practice addresses (Care Compare)

1221 Highland Ave
Clarkston, WA 99403-2829
Phone (509) 758-5511

320 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 743-3523

808 Port Dr
Clarkston, WA 99403-6009
Phone (208) 746-1383

PO Box
Suite 189
Clarkston, WA 99403-0189

Hospital & facility affiliations

  • Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332
  • St Mary'S Hospital Hospital, Cottonwood, ID, CCN 131321
  • Syringa General Hospital Hospital, Grangeville, ID, CCN 131315
  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement20
Knee replacement20
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9722IDMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Memorial Hospital CurrentSince Sep 1, 2025 Accepting new patients
Tri-State Memorial Hospital CurrentSince Sep 1, 2025 Accepting new patients
Catalyst Medical Group, PLLC CurrentSince Jan 1, 2017 Accepting new patients
Tri-State Memorial Hospital CurrentSince Jan 1, 2026 Accepting new patients
Tri-State Memorial Hospital Past Accepting new patients

Locations

320 Warner Dr
Lewiston, ID 83501
Phone (208) 298-1022

318 Warner Dr
Lewiston, ID 83501
Phone (208) 298-1050

2315 8th St Grade
Lewiston, ID 83501
Phone (208) 746-1383

1174 Alturas Dr
Moscow, ID 83843
Phone (208) 743-3523

1207 Evergreen Ct
Clarkston, WA 99403
Phone (509) 751-0600

1267 Belmont Way
Clarkston, WA 99403
Phone (509) 751-1500

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

808 Port Dr
Clarkston, WA 99403
Phone (208) 746-1383

Interoperability endpoints

  • Direct secure messaging: bbeardsley@cmgadmin.directmessaging.net

Organizations & group practices 6

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 11

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1104856087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994030189",
            "telephone_number": "509-769-2254",
            "fax_number": "509-769-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 EVERGREEN CT",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032874",
            "telephone_number": "509-769-2255",
            "fax_number": "509-769-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDSLEY",
        "first_name": "BRYAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M9722",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD00044939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807636400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8169918",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS OF IDAHO",
            "identifier": "76800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "000010159447",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

Verify at the official NPI Registry.