NPIMap

Individual provider Active NPI

Charles Beaudoin, CRNA

  • Certified Registered Nurse Anesthetist
  • Lubbock, TX
National Provider Identifier
1265894638
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP130640 Issued in TX
Practice address
3601 4TH St
Ms8182
Lubbock, TX 79430-0002
Phone
(806) 743-9945
NPI assigned
Mar 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP130640 TX Primary

Addresses

Primary practice location

3601 4TH St
Ms8182
Lubbock, TX 79430-0002

Mailing address

3601 4TH St
Ms8182
Lubbock, TX 79430-0002

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charles.beaudoin@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160404000126 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850698028 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia PAGroup PAC ID 7315907128, 231 clinicians

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9436
Phone (806) 743-2475

3615 19TH St
Lubbock, TX 79410-1203
Phone (806) 725-0000

6200 W Parker Rd
Plano, TX 75093-7939
Phone (972) 608-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP130640TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2016 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 17, 2025 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 17, 2025 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Apr 1, 2016 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3601 4th St
Stop 8182
Lubbock, TX 79430
Phone (806) 743-2981

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

Organizations & group practices 8

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 5

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1265894638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "MS8182",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "MS8182",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "CHARLES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP130640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.beaudoin@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "address_2": "MS8182",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.