NPIMap

Individual provider Active NPI

Michelle Marie Beshaw, PA-C

  • Physician Assistant
  • Clinton, OK
National Provider Identifier
1457605347
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4362 Issued in MA
Practice address
RR 1 Box 3060
Clinton, OK 73601-9303
Phone
(580) 331-3300
Fax
(580) 331-3565
NPI assigned
Oct 31, 2012
Last updated
Oct 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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 PA4362 MA Primary

Addresses

Primary practice location

RR 1 Box 3060
Clinton, OK 73601-9303

Mailing address

RR 1 Box 3060
Clinton, OK 73601-9303
Phone (580) 331-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130223000010 TX Practitioner - Physician Assistant 6002061017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinton Indian Health CenterGroup PAC ID 2163324237, 74 clinicians

Practice addresses (Care Compare)

10321 N
Suite 2274
Clinton, OK 73601-7521

10321 N 2274 Rd
Clinton, OK 73601-7521
Phone (580) 331-3410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA4362MAMDPhysician Assistant

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1457605347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 3060",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736019303",
            "telephone_number": "580-331-3300",
            "fax_number": "580-331-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 3060",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736019303",
            "telephone_number": "580-331-3300",
            "fax_number": "580-331-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESHAW",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, OK

Sources for this page

Verify at the official NPI Registry.