Marc Domina Beaudin, MD, PHD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

840 Harrison Ave
Department of Pediatrics, Dowling 3 South
Boston, MA 02118-2999

Phone

(347) 669-4319

NPI assigned

Mar 21, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Interoperability endpoints

• Direct secure messaging: mbeaudin173288@direct.bmc.masshiway.net
• Direct secure messaging: mbeaudin23329@direct.bostonchildrens.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.

• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1700535507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 AUBURN ST APT 5",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484056",
            "telephone_number": "347-669-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HARRISON AVE",
            "address_2": "DEPARTMENT OF PEDIATRICS, DOWLING 3 SOUTH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182999",
            "telephone_number": "347-669-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDIN",
        "first_name": "MARC",
        "middle_name": "DOMINA",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Beatty, PA-C, MSPT
• Morgan Elizabeth Beaty
• Soraya Beaubrun, FNP-BC
• Kathryn Ann Beauchamp, RN, MSN, CCRN, CCNS
• Lori E Beauchamp, PA-C
• Rowen Beaudoin-Colegrove
• Holly Beaudoin, RCIS
• Corinne Beaugard
• Laurence Beaulieu-Genest, MD, FRCPC
• Brendin Ryan Beaulieu-Jones, MD/MBA

• Student in an Organized Health Care Education/Training Program in Boston, MA
• Providers in Boston, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.