Maura T Beardsley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008327 Issued in MI

Practice address

1970 S Ridge Rd
Green Bay, WI 54304-4125

Phone

(920) 430-4888

Fax

(920) 430-4889

NPI assigned

Oct 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Maura T Monahan Former name

Medicare fee-for-service enrollment

Enrolled in WI, MI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, shared by 10 NPIs, 685 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmonahan163112@direct.thedacare.org

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.

• Oconto Hospital & Medical Center Inc

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302

  Multi-Specialty, WI

  Medicare reassignment NPD (past)
• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473

  WI

  Medicare reassignment
• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Crystal Falls, MI
  • NPI 1376649509

  MI

  Medicare reassignment
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • De Pere, WI
  • NPI 1053374314

  Multi-Specialty

  NPD
• Oconto Hospital & Medical Center Inc

  • Rural Health Clinic/Center
  • Suring, WI
  • NPI 1104418037

  Multi-Specialty

  NPD
• Oconto Hospital & Medical Center, Inc.

  • Rural Health Clinic/Center
  • Oconto, WI
  • NPI 1609018589

  Multi-Specialty

  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784

  Multi-Specialty

  NPD (past)

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

• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1588068902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044125",
            "telephone_number": "920-430-4888",
            "fax_number": "920-430-4889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3263 Eaton Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116830",
            "country_code": "US",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2714 Riverview Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543136715",
            "country_code": "US",
            "telephone_number": "920-430-4760",
            "fax_number": "920-430-4774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Iron Mountain",
            "state": "MI",
            "postal_code": "498014631",
            "country_code": "US",
            "telephone_number": "906-776-9040",
            "fax_number": "920-430-8124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "fax_number": "715-735-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEARDSLEY",
        "first_name": "MAURA",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008327",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3456-23",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1112310",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURA",
            "last_name": "MONAHAN",
            "middle_name": "T",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyssa Rose Baye, MS, MFT-IT
• Gerald K Bayer, M.D.
• Baylakes Center for Complex Dentistry SC
• Bayshore Counseling Network
• Taylor Beadles
• Courtney R Beaudette, APNP
• Rebecca Lorraine Beaumia, NP
• Deanne Marie Beaumier, APSW
• Nicole Beauprey, PTA
• Joan Bechard, RN

• All providers in Green Bay, WI
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.