NPIMap

Individual provider Active NPI

Mason Frederick Beaudry, PA-C

  • Physician Assistant
  • Batavia, NY
National Provider Identifier
1396303301
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12948 Issued in TX
Practice address
127 North Street
Batavia, NY 14020
Phone
(585) 343-6030
NPI assigned
Jun 4, 2019
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12948 TX Primary

Addresses

Primary practice location

127 North Street
Batavia, NY 14020

Mailing address

100 Kings Highway South
Rochester, NY 14617-5504
Phone (585) 922-1900

Other practice location 1

140 Hillcrest Medical Blvd Ste 2
Waco, TX 76712-8897
Phone (254) 741-1400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbeaudry534028@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205000962 NY Practitioner - Physician Assistant 8426385386 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

1445 Portland Ave
Rochester, NY 14621-3008

2000 Empire Blvd
Webster, NY 14580-1957

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
030012NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Oct 7, 2024 Accepting new patients
Rochester General Hospital Physician Assistant CurrentSince Oct 7, 2024 Accepting new patients
Rochester General Hospital CurrentSince Oct 7, 2024 Accepting new patients
Newark Wayne Community Hospital CurrentSince Oct 7, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince Oct 7, 2024 Accepting new patients
Hillcrest Physician Services PastSince Dec 1, 2021 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2170

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Interoperability endpoints

  • Direct secure messaging: mbeaudry373130@direct.rochesterregional.org
  • Direct secure messaging: mbeaudry534028@direct.sw.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1396303301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HIGHWAY SOUTH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NORTH STREET",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "14020",
            "telephone_number": "585-343-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Hillcrest Medical Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767128897",
            "country_code": "US",
            "telephone_number": "254-741-1400",
            "fax_number": "254-741-1428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUDRY",
        "first_name": "MASON",
        "middle_name": "FREDERICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbeaudry534028@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "140 Hillcrest Medical Blvd Ste 2",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

Verify at the official NPI Registry.