Individual provider Active NPI

Lakshmi R. Beeravolu, MD

  • Clinical Neurophysiology Physician
  • Belleville, IL
National Provider Identifier
1376745117
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
036131387 Issued in IL
Practice address
4550 Memorial Dr
Ste. A480
Belleville, IL 62226-5372
Phone
(618) 234-4531
Fax
(618) 234-4695
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2014029851 MO
Clinical Neurophysiology Physician 2084N0600X 2014029851 MO
Neurology Physician 2084N0400X ME129984 FL
Clinical Neurophysiology Physician 2084N0600X 036131387 IL Primary

Addresses

Primary practice location

4550 Memorial Dr
Ste. A480
Belleville, IL 62226-5372

Mailing address

4550 Memorial Dr
Ste. A480
Belleville, IL 62226-5372
Phone (618) 234-4531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, AR, SC, TX, AL, WI, NM, CT, NV, MT, OK, LA, NC, CA, FL15 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 15

Enrollment IDStateProvider typePAC IDDetails
I20101214000101 PA Practitioner - NeurologyPractitioner - Neuropsychiatry 5890982011 Reassigns benefits to 1 organization
I20191209001455 AR Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20230720001366 SC Practitioner - Neurology 5890982011
I20230724001309 TX Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20230818000351 AL Practitioner - Neurology 5890982011
I20250103002811 WI Practitioner - Neurology 5890982011
I20250107003326 NM Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20250122001943 CT Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20250122002492 NV Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20250207003510 MT Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20250305001095 OK Practitioner - Neurology 5890982011
I20250318003619 LA Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20250407001119 NC Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20250728000594 CA Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization
I20260109000005 FL Practitioner - Neurology 5890982011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians
Public Health Trust of Miami Dade County FloridaGroup PAC ID 0244380434, 469 clinicians

Practice addresses (Care Compare)

Spring, TX 77382
Phone (972) 449-0540

10501 Golf Course Rd NW
Albuquerque, NM 87114-5019
Phone (972) 449-0540

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

2 Calle Final
Placitas, NM 87043-9214
Phone (972) 449-0540

20 York St
New Haven, CT 06510-3220
Phone (972) 449-0540

208 Sologne CT
Little Rock, AR 72223-8915
Phone (972) 449-0540

4311 E Lohman Ave
Las Cruces, NM 88011-8255
Phone (972) 449-0540

50 Hospital Hill Rd
Sharon, CT 06069-2096
Phone (972) 449-0540

850 W Central Texas Expy
Harker Heights, TX 76548-1890
Phone (972) 449-0540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME129984FLMDNeurology Physician
2014029851MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Oct 31, 2025 Accepting new patients
Access Telecare California, P.C. Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Public Health Trust of Dade County Florida CurrentSince Oct 31, 2025 Accepting new patients
Mercy Management of Southeastern Pennsylvania Past Accepting new patients
Msa Alliance, LLC Neurology Past Accepting new patients

Locations

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

400 Old River Rd
Bakersfield, CA 93311
Phone (661) 663-6000

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

450 E Romie Ln
Salinas, CA 93901
Phone (831) 372-7844

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1717 Main St
Ste 5850
Dallas, TX 75201
Phone (469) 694-5512

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1376745117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. A480",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-234-4531",
            "fax_number": "618-234-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. A480",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-234-4531",
            "fax_number": "618-234-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEERAVOLU",
        "first_name": "LAKSHMI",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2014029851",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MO",
            "license": "2014029851",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME129984",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "036131387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.