Individual provider Active NPI

Brent Beirdneau, DPM

  • Foot & Ankle Surgery Podiatrist
  • Salem, OR
National Provider Identifier
1417303637
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DP204042 Issued in OR
Practice address
1750 13TH St SE
Salem, OR 97302-2542
Phone
(503) 588-8188
NPI assigned
May 6, 2016
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X DP204042 OR
Foot & Ankle Surgery Podiatrist 213ES0103X DP204042 OR Primary

Addresses

Primary practice location

1750 13TH St SE
Salem, OR 97302-2542

Mailing address

1750 13TH St SE
Salem, OR 97302-2542
Phone (503) 588-8188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220521000403 OR Practitioner - Podiatry 7719274703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trevor Tippets DPM LLCGroup PAC ID 8123456233, 5 clinicians

Practice addresses (Care Compare)

1750 13TH St SE
Salem, OR 97302-2542
Phone (503) 588-8188

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.16 of 100Reported as group
Quality
51.99
Promoting interoperability
0
Improvement activities
0
Cost
99.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue113
Removal of skin lesions1-10
Removal of nail tissue353
Removal or shaving of skin growth131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP204042ORMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Trevor Tippets DPM LLC Single Specialty CurrentSince Jun 27, 2022 Accepting new patients
Salem Health Single Specialty Past Accepting new patients

Locations

3474 Liberty Rd S
Salem, OR 97302
Phone (503) 588-8188

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1417303637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022542",
            "telephone_number": "503-588-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022542",
            "telephone_number": "503-588-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEIRDNEAU",
        "first_name": "BRENT",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OR",
            "license": "DP204042",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OR",
            "license": "DP204042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.