Michael Alan Beasley, M.D.

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

MD483528 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-1000

Fax

(267) 876-2181

NPI assigned

Nov 13, 2009

Last updated

Nov 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children's Surgical Associates LTD

  • Plastic Surgery Physician
  • Philadelphia, PA
  • NPI 1326117185
  Medicare reassignment NPD
• Children's Surgical Associates LTD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Philadelphia, PA
  • NPI 1730268079
  NPD
• Children's Surgical Associates, LTD

  • Optometrist
  • Philadelphia, PA
  • NPI 1134525934
  NPD
• Children's Surgical Associates LTD

  • Pediatric Surgery Physician
  • Philadelphia, PA
  • NPI 1760562581

  Sports Medicine

  NPD (past)
• Children's Sports Medicine Foundation

  • Sports Medicine Podiatrist
  • Boston, MA
  • NPI 1861680720
  NPD (past)

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1407183353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000",
            "fax_number": "267-876-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000",
            "fax_number": "267-876-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-13",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "PA",
            "license": "MD483528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "525196",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104285805",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS LICENSE",
            "identifier": "247169",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYEE NUMBER",
            "identifier": "900001779",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Beard, DC
• Marc Beard, PHARM.D.
• Anna Bearden
• David Bearden, M.D.
• Renee Y Bearman, CRNP
• William Edward Beatie, MD
• Julia Rose Beatini, MD
• Alexis Beattie, M.D.
• Katherine Claire Beattie, MD, PHD
• Evan William Beatty, MD

• Pediatric Sports Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Sports Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.

Verify at the official NPI Registry.