Active NPI
John Mark Beard, MD
- Family Medicine Physician
- Mukilteo, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00025677
- Practice address
- 4410 106TH St SW
Mukilteo, WA 98275-4700 - Phone
- (425) 493-6000
- NPI assigned
- Oct 16, 2006
- Last updated
- Mar 15, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00025677 | WA | Primary |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | MD00025677 | WA |
Addresses
Primary practice location
4410 106TH St SW
Mukilteo, WA 98275-4700
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (425) 493-6000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1005385 | Medicaid | WA | |
| 0230703 | Other | WA | L&I |
| 2005974 | Other | INTERNAL ID-MOTOR VEHICLE ID | |
| 1225118201 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Missouri, Columbia School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 E Jackson Ave
Ellensburg, WA 98926-3692
Phone (509) 933-8777
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00025677 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| Kittitas County Public Hospital Dist 1 | Current | Accepting new patients | |
| Kittitas County Public Hosp Dist 1 | Current | Accepting new patients | |
| Kittitas County Public Hospital Dist 1 | Current | Accepting new patients | |
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| Kittitas County Public Hospital Dist 1 | Past | Accepting new patients |
Locations
100 E Jackson Ave
Ellensburg, WA 98926
Phone (509) 574-6000
603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
4410 106th St SW
Mukilteo, WA 98275
Phone (206) 388-6000
1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Kittitas Valley Community Hospital
- Critical Access Hospital
- Ellensburg, WA
- NPI 1356375307
-
dba KVH General Surgery
- Specialist
- Ellensburg, WA
- NPI 1790910057
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
Family Medicine
-
dba KVH Internal Medicine
- Rural Health Clinic/Center
- Ellensburg, WA
- NPI 1932115391
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kittitas Valley Community Hospital
- Critical Access Hospital
- Ellensburg, WA
- NPI 1356375307
-
- Home Health Agency
- Ellensburg, WA
- NPI 1376561654
-
dba MultiCare Yakima Memorial Hospital
- General Acute Care Hospital
- Yakima, WA
- NPI 1053373480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1225118201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127",
"telephone_number": "425-493-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 106TH ST SW",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "982754700",
"telephone_number": "425-493-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARD",
"first_name": "JOHN",
"middle_name": "MARK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00025677",
"primary": true
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "WA",
"license": "MD00025677",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1005385",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0230703",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL ID-MOTOR VEHICLE ID",
"identifier": "2005974",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1225118201",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mukilteo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.