Active NPI
Richard Beaty, D.O.
- Orthopaedic Surgery Physician
- Evergreen Park, IL
National Provider Identifier
1316986839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 36054433
- Practice address
- 2850 W 95TH St Ste 406
Evergreen Park, IL 60805-2790 - Phone
- (708) 873-3200
- Fax
- (708) 873-3203
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 36054433 | IL | Primary |
Addresses
Primary practice location
2850 W 95TH St Ste 406
Evergreen Park, IL 60805-2790
Mailing address
PO Box 369
New Lenox, IL 60451-0369
Phone (815) 463-0098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080821000286 | IL | Practitioner - Orthopedic Surgery | 4688749997 | Practice locations: Evergreen Park, IL; Palos Heights, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36054433 | IL | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370390400000",
"number": "1316986839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 369",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604510369",
"telephone_number": "815-463-0098",
"fax_number": "815-462-4955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 W 95TH ST STE 406",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052790",
"telephone_number": "708-873-3200",
"fax_number": "708-873-3203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATY",
"first_name": "RICHARD",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2013-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "36054433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.