Active NPI
Tatyana Beaubrun, MD
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1306331269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2018018677
- Practice address
- 1 Childrens PL # 3S34
Saint Louis, MO 63110-1002 - Phone
- (314) 454-6006
- NPI assigned
- Jun 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2018018677 | MO | Primary |
Addresses
Primary practice location
1 Childrens PL # 3S34
Saint Louis, MO 63110-1002
Mailing address
1 Childrens PL # 3S34
Saint Louis, MO 63110-1002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 82.13 of 100
- Quality
- 72.13
- Promoting interoperability
- 91
- Improvement activities
- 40
- Cost
- 75.81
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018018677 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Medical Care, P.C. | Current | Accepting new patients | |
| Optum Medical Care, P.C. | Current | Accepting new patients | |
| Mount Kisco Medical Group | Past | Accepting new patients |
Locations
2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763
90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050
110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192
Philadelphia, PA 19195
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Mount Kisco, NY
- NPI 1982643003
-
- Durable Medical Equipment & Medical Supplies
- New Hyde Park, NY
- NPI 1053190595
-
- Hematology (Internal Medicine) Physician
- Fishkill, NY
- NPI 1952356362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529798400000",
"number": "1306331269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL # 3S34",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL # 3S34",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-6006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUBRUN",
"first_name": "TATYANA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-24",
"last_updated": "2018-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2018018677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2018; 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.