Individual provider Active NPI

Matthew Robert Beatty, PA-C

  • Physician Assistant
  • Woodbury, MN
National Provider Identifier
1558537860
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10418 Issued in MN
Practice address
1925 Woodwinds Dr
Woodbury, MN 55125-2270
Phone
(651) 232-0228
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MN
Physician Assistant 363A00000X 10418 MN Primary

Addresses

Primary practice location

1925 Woodwinds Dr
Woodbury, MN 55125-2270

Mailing address

800 E 28TH St # Mr 11112
Minneapolis, MN 55407-3723
Phone (612) 863-6590

Other practice location 1

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7348

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081215000795 MN Practitioner - Physician Assistant 3173685856 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

1000 W 140TH St
Unit 201
Burnsville, MN 55337-4833
Phone (952) 808-3000

2700 Vikings Cir
Eagan, MN 55121-1002
Phone (952) 456-7600

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10418MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Feb 20, 2023 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Feb 20, 2023 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients

Locations

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

800 E 28th St
#11112
Minneapolis, MN 55407
Phone (612) 863-4233

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

4040 Radio Dr
Ste 200
Woodbury, MN 55129

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1558537860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST # MR 11112",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-6590",
            "fax_number": "612-863-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252270",
            "telephone_number": "651-232-0228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 Beam Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091126",
            "country_code": "US",
            "telephone_number": "651-232-7348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.