NPIMap

Individual provider Active NPI

Beau John Elkington, LICSW, LADC, MBA

  • Clinical Social Worker
  • Fridley, MN
National Provider Identifier
1437633575
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22916 Issued in MN
Practice address
7590 Lyric LN NE Ste 114
Fridley, MN 55432-3251
Phone
(763) 236-4373
Fax
(763) 236-4370
NPI assigned
Sep 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 304158 MN
Clinical Social Worker 1041C0700X 22916 MN Primary

Addresses

Primary practice location

7590 Lyric LN NE Ste 114
Fridley, MN 55432-3251

Mailing address

7590 Lyric LN NE Ste 114
Fridley, MN 55432-3251
Phone (763) 236-4508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20190122002440 MN Practitioner - Clinical Social Worker 3375880883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

520 Osborne Rd NE
Suite 120
Fridley, MN 55432-2718
Phone (763) 236-4300

Hospital & facility affiliations

  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
304158MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jan 14, 2019 Accepting new patients
Allina Health System CurrentSince Jan 14, 2019 Accepting new patients

Locations

520 Osborne Rd NE
Ste 120
Fridley, MN 55432
Phone (763) 236-4300

7590 Lyric Ln NE
Minneapolis, MN 55432
Phone (763) 236-3800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

Interoperability endpoints

  • Direct secure messaging: belkington364003@excellian.direct.allina.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1437633575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 LYRIC LN NE STE 114",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323251",
            "telephone_number": "763-236-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7590 LYRIC LN NE STE 114",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323251",
            "telephone_number": "763-236-4373",
            "fax_number": "763-236-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKINGTON",
        "first_name": "BEAU",
        "middle_name": "JOHN",
        "credential": "LICSW, LADC, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304158",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.