Individual provider Active NPI

Jacob Michael Beadles, AUD.

  • Audiologist
  • Tigard, OR
National Provider Identifier
1689174963
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
030904 Issued in OR
Practice address
6750 SW Franklin St Ste a
Tigard, OR 97223-2520
Phone
(503) 227-3668
Fax
(503) 227-2234
NPI assigned
Feb 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 030904 OR Primary

Addresses

Primary practice location

6750 SW Franklin St Ste a
Tigard, OR 97223-2520

Mailing address

6750 SW Franklin St Ste a
Tigard, OR 97223-2520
Phone (503) 227-3668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250930000341 OR Practitioner - Qualified Audiologist 0042716037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Audiology Clinic LLCGroup PAC ID 8022519958, 2 clinicians

Practice addresses (Care Compare)

6750 SW Franklin St
Suite a
Tigard, OR 97223-2520
Phone (503) 227-3668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Audiology Clinic, LLC Audiologist CurrentSince Jul 17, 2025 Accepting new patients

Locations

6750 SW Franklin St
Ste A
Tigard, OR 97223
Phone (503) 227-3668

9735 SW Shady Ln
Ste 302
Tigard, OR 97223

Organizations & group practices 2

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": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1689174963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 SW FRANKLIN ST STE A",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232520",
            "telephone_number": "503-227-3668",
            "fax_number": "503-227-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 SW FRANKLIN ST STE A",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232520",
            "telephone_number": "503-227-3668",
            "fax_number": "503-227-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEADLES",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "AUD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-13",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "030904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.