Beaver Medical Group, LP

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

BEAVER MEDICAL GROUP, LP

Practice address

259 Terracina Blvd
Redlands, CA 92373-4847

Phone

(909) 793-2634

Fax

(909) 796-4158

NPI assigned

Jun 2, 2006

Reactivated

Nov 9, 2012

Last updated

Feb 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles T ChenNPI 1124050463

Title

Senior Medical Director

Phone

(909) 793-3311

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Beaver Medical Group P C

  • Internal Medicine Physician
  • Colton, CA
  • NPI 1144265919

  O20031124000449

  Same enrollment
• Beaver Medical Group P C

  • Internal Medicine Physician
  • Highland, CA
  • NPI 1598706293

  O20031124000449

  Same enrollment
• Beaver Medical Group P C

  dba Optum Banner Specialty Care

  • Internal Medicine Physician
  • Banning, CA
  • NPI 1619914959

  O20031124000449

  Same enrollment
• Beaver Medical Group P C

  dba Optum

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319

  O20031124000449

  Same enrollment
• Beaver Medical Group PC

  • Family Medicine Physician
  • Yucaipa, CA
  • NPI 1205013323

  O20031124000449

  Same enrollment
• Beaver Medical Group, LP

  • Pediatrics Physician
  • Banning, CA
  • NPI 1457372179

  O20031124000449

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles T Chen, M.D.

  • Internal Medicine Physician
  • Redlands, CA
  • NPI 1124050463
  Authorized official Same address or phone

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1326085663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 TERRACINA BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734847",
            "telephone_number": "909-793-2634",
            "fax_number": "909-796-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER MEDICAL GROUP, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "deactivation_date": "2009-09-10",
        "reactivation_date": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SENIOR MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-793-3311"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beaver Medical Group P C
• Beaver Medical Group P C (Beaver Medical Group - Primary Care North)
• Beaver Medical Group P C (Optum)
• Beaver Medical Group P C
• Beaver Medical Group, L.P.
• Beaver Medical Group, LP
• Steven Beck, M.D.
• Melisa Raquel Beckley, D.D.S.
• Adrianne Latrice Bedeau
• Sarah Beene, MS, ATC

• Orthopaedic Surgery Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.