NPIMap

Individual provider Active NPI

Bryan S Beck, MD

  • Cardiovascular Disease Physician
  • Cape Girardeau, MO
National Provider Identifier
1720018179
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2004012258 Issued in MO
Practice address
371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone
(573) 334-6008
Fax
(573) 334-1713
NPI assigned
Jul 3, 2006
Last updated
Jul 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2004012258 MO Primary

Addresses

Primary practice location

371 S Broadview St
Cape Girardeau, MO 63703-5761

Mailing address

371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone (573) 334-6008

Other identifiers 1

IdentifierTypeStateIssuer
208757401MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041027000566 MO Practitioner - Cardiovascular Disease (Cardiology) 3870555436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
George Washington University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 N One Mile Rd
Dexter, MO 63841-1001

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

2002 Kanell Blvd
Suite 203
Poplar Bluff, MO 63901-4011
Phone (573) 727-9150

371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone (573) 331-6710

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.94 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
79.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Hospital CurrentSince Jul 1, 2004 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
Southeast Hospital CurrentSince Jul 1, 2004 Accepting new patients

Locations

371 S Broadview St
Cape Girardeau, MO 63703
Phone (573) 331-6710

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

25 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 331-6750

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1720018179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035761",
            "telephone_number": "573-334-6008",
            "fax_number": "573-334-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035761",
            "telephone_number": "573-334-6008",
            "fax_number": "573-334-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "BRYAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2004012258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208757401",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.