Beau James Ellenbecker, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P1069 Issued in TX

Practice address

610 E Byron Nelson Blvd
Suite 101
Roanoke, TX 76262-6541

Phone

(817) 912-8200

Fax

(817) 912-8210

NPI assigned

May 29, 2007

Last updated

Mar 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Fort Worth Home health agency, Fort Worth, TX, CCN 747526
• Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563
• Baylor Institute for Rehabilitation at Frisco Inpatient rehabilitation facility, Frisco, TX, CCN 673046

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bellenbecker225668@direct.sw.org

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD

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

• Baylor Regional Medical Center at Grapevine

  dba Baylor Scott & White Medical Center - Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
  • NPI 1073511762
  Care Compare affiliation
• Bir JV LLP

  • Rehabilitation Hospital
  • Frisco, TX
  • NPI 1285930891

  Inpatient rehabilitation facility

  Care Compare affiliation
• Texas Home Health Group of Fort Worth, LLC

  dba AccentCare Home Health of Fort Worth

  • Home Health Agency
  • Fort Worth, TX
  • NPI 1023548930
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1679774582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E BYRON NELSON BLVD",
            "address_2": "SUITE 101",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762626541",
            "telephone_number": "817-912-8200",
            "fax_number": "817-912-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E BYRON NELSON BLVD",
            "address_2": "SUITE 101",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762626541",
            "telephone_number": "817-912-8200",
            "fax_number": "817-912-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBECKER",
        "first_name": "BEAU",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307543401",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bellenbecker225668@direct.sw.org",
            "affiliation": "N",
            "address_1": "2800 E Highway 114 Ste 220",
            "city": "Trophy Club",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762625307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Holly Kristen Dickson, P.T.
• Discovery Tox, LLC
• Doyle Chiropractic LLC
• E&O Consultancy Services Inc
• Sloane Ehler
• Alexis Espinosa, DC
• Melissa Esquivel, DDS
• Caitlin Fierro
• Debra Elaine Finney
• First Family Care, PLLC (First Med)

• Family Medicine Physician in Roanoke, TX
• Providers in Roanoke, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.